YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism in Patients With Cancer: A Randomized Clinical Trial.

The YEARS algorithm safely reduces CTPA use by 22% in cancer patients with suspected pulmonary embolism, with a primary outcome risk difference of -3.7%.

• Why it matters: Accurate, efficient diagnosis of PE in cancer patients is critical to avoid unnecessary imaging and associated risks, yet current guidelines favor direct CTPA, which may lead to overuse.
• What they did: A randomized trial compared the YEARS algorithm, incorporating clinical assessment and D-dimer testing, to CTPA-only management in 698 patients with active cancer across multiple European hospitals.
• The result: The YEARS strategy was noninferior in safety, with fewer CTPA procedures performed without increasing PE-related adverse events, enabling safer, more efficient diagnosis in this high-risk group.