Abstract
This systematic review and meta-analysis aimed to assess the diagnostic accuracy of the YEARS algorithm in excluding pulmonary embolism, as well as to compare the utilisation of advanced imaging modalities between the YEARS approach and standard clinical practice. Eligible studies were identified from multiple databases spanning July 2017 to September 2022, following the Joanna Briggs Institute methodology for diagnostic accuracy reviews. A total of 10 studies, involving approximately 14,000 participants, were included in the analysis. The YEARS algorithm demonstrated a sensitivity of 96% (95% confidence interval [CI]: 93-98%) and a specificity of 50% (95% CI: 33-67%). Additonally, the risk ratio for advanced imaging utilisation was 0.78 (95% CI: 67-90), indicating a significant reduction in imaging use. These findings suggest that the YEARS is an effective and safe strategy for managing patients with suspected pulmonary embolism.