Venous thromboembolim (including pulmonary embolism and deep venous thrombosis) causes 60,000 deaths each year in the US. The mortality rate associated with PE exceeds 15% in the first three months after diagnosis. A massive pulmornary…

1. Your Nomination - Please briefly describe in your own words the question about a health care test or treatment that interests or concerns you:: Venous thromboembolim (including pulmonary embolism and deep venous thrombosis) causes 60,000 deaths each year in the US. The mortality rate associated with PE exceeds 15% in the first three months after diagnosis. A massive pulmornary embolism isa life threatening condition. Treatment options include thrombolytics, surgery and more recently mechanicl thrombectomy devices are proposed as a treatment option. What mechanical thrombectomy devices are avialalbe in patients with massive pulmonary embolism (or DVT)? What are the advantages and disadvantages of such interventions compared to thrombolysis or surgery? What are the associated harms? What instrumentation is required?

2. Why do you think your question is important? (you may select more than one category if appropriate): My question relates to a very common disease or problem
People with this disease or problem have considerable health or financial hardships
There is uncertainty about how well the test, treatment, or intervention works
There is significant potential for side effects/harms using this test, treatment, or intervention
Funding of this test, treatment, or intervention is uncertain or variable
There is unequal access or application of this health care intervention across providers
There is potential for cost savings from better information on this subject
This is a new technology/development
There is new evidence of clinical and/or cost effectiveness for this test, treatment, or intervention
Other

3. What illness or health condition is related to your question? (You can also specify a particular health-promoting activity, such as breast-feeding): Pulmonary embolism (and DVT)

4. What group(s) or patients does your question apply to?: Patients with massive PE

5. What is the specific purpose of the health care test or treatment you have a question about? (mark all that you think apply): Identification of a disease or condition:
Screening or diagnosis/identification for a particular disease, or risk assessment for a disease
Risks or harms that can come from a disease identification tool or test
Diagnostic tests and tools
Diagnosis of co-occurring diseases
Intervention (such as a drug treatment, therapy, device)
Management of a condition or particular system of care
Delivery of a health service
Referral
Risks or harms associated with treatment of a disease or condition
Prevention or health promotion
Specific population health concerns, such as ethnic group or gender
Other
Dont know

6. Does your question include a comparison of different health care approaches?: Yes
If yes, please list what you would like to see compared:
Among patients with massive PE (and perhaps assoicated right ventricular failure cardiogenic shock etc) how do these mechanical devices compare with thrombolytics? with surgery?

7. Desired Health Improvements: If you question focuses on:: Identification of a particular disease or condition, what improvements in identification or diagnosis would you like to see?

Treatment of a particular disease or condition, what improvements in patient symptoms or problems would you like to see? Improved mortality, improved morbidity, reduced complications from bleeding that may occur with thromolytics), reductions in the number of patients with PE who need to undergo surgery.

8. Harms: Are there risks, side effects, or harms you are concerned about? If yes, please specify what those are:: concerns regarding bleeding, perforation of vessel, heart (ie. rt ventricle)

9. Based on your answers to the previous questions, what research question(s) would you like to have answered?: What mechanical thrombectomy devices are avialalbe in patients with massive pulmonary embolism (or DVT)? What are the advantages and disadvantages of such interventions compared to thrombolysis or surgery? What are the associated harms? What instrumentation is required?

10. Are there health-care focused, disease-focused, or patient-focused organizations that you see as being relevant to this issue? Who do you think we should contact as we consider your nomination?: American college of chest physicians American thoracic society American association of cardiothoracic surgeons

11. Other Information About You (OPTIONAL) In order to help us understand the context of your health care question, it would be helpful to know more about you. The answers you give will not influence the progress of your suggestion. Thank you.: a. Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
Other

b. Is there any other information about you that is relevant to your question?

c. Are you making a suggestion as an individual or on behalf of an organization?
Individual
Organization

Effective Health Care Program