Background: Pulmonary embolism (PE), depending on the severity, carries a high mortality and morbidity. Proper evaluation, especially in patients with low probability for PE, is important to avoid unnecessary diagnostic testing. Objective: To review the diagnostic utility of conventional versus age-adjusted D-dimer cutoff values in patients 50 years and older with suspected pulmonary embolism. Methods: Systematic review with univariant and bivariant meta-analysis. Data sources: We searched PubMed, MEDLINE, and EBSCO for studies published before September 20th, 2020. We cross checked the reference list of relevant studies that compares conventional versus age-adjusted D-dimer cutoff values in patients with suspected pulmonary embolism. Study selection: We included primary published studies that compared both conventional (500 µg/L) and age-adjusted (age × 10 µg/L) cutoff values in patients with non-high clinical probability for pulmonary embolism. Results: Nine cohorts that included 47 720 patients with non-high clinical probability were included in the meta-analysis. Both Age-adjusted D-dimer and conventional D-dimer have high sensitivity. However, conventional D-dimer has higher false positive rate than age-adjusted D-dimer. Conclusion: Age-adjusted D-dimer cutoffs combined with low risk clinical probability assessment ruled out PE diagnosis in suspected patients with a decreased rate of false positive tests.

Colorectal cancer is the second most common cause of cancer death in both men and women. Although the overall incidence and mortality rates of colorectal cancer are declining, African Americans have significantly higher rates of colorectal cancer than Caucasians, and they have worse 5-year survival rates. This article reviews some of the contributing factors that lead to this racial disparity in colorectal cancer between these groups. The increase in poor health outcomes among African Americans is due to low socioeconomic standing, poor compliance, psychosocial barriers, and patient mistrust of healthcare providers and the healthcare system. Research on interventions to improve health outcomes is important to reduce the causes of these disparities. Keywords: colorectal cancer; screening; African Americans; Blacks; health disparities; interventions; public health