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............................. determination and the implementation of preventive, diagnostic or therapeutic medical strategies. However, the ESC Guidelines do not override in any way whatsoever the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient’s health condition and in consultation with that patient or the patient’s caregiver where appropriate and/or necessary. It is also the health professional’s responsibility to verify the rules and regulations applicable in each country to drugs and devices at the time of prescription. 2 Introduction

2.1 Why do we need new Guidelines on

the diagnosis and management of pulmonary embolism? This document follows the previous ESC Guidelines focusing on the clinical management of pulmonary embolism (PE), published in 2000, 2008, and 2014. Many recommendations have been retained or their validity has been reinforced; however, new data have extended or

Table 2 Levels of evidence

©ESC 2019

Level of evidence A Data derived from multiple randomized clinical trials or meta-analyses.

Level of evidence B Data derived from a single randomized clinical trial or large non-randomized studies.

Level of evidence C Consensus of opinion of the experts and/or small studies, retrospective studies, registries.

Table 1 Classes of recommendations

©ESC 2019

Classes of recommendations Class I Evidence and/or general agreement that a given treatment or procedure is Is recommended or is indicated

Wording to use

Class III Evidence or general agreement that the given treatment or procedure is not useful/effective, and in some cases may be harmful. Is not recommended

Class IIb

established by evidence/opinion. May be considered

Class IIa Weight of evidence/opinion is in Should be considered

Class II

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