"This group is probably just diagnosing more incidental PEs and might be causing net harm"
While I appreciate that the point here was to raise the question of the clinical significance of the additional PEs identified, a true "incidental finding" would usually be finding something you weren't looking for with the test you ordered. Finding even a small PE on a CTPA in my mind would not fairly be called an incidental finding since looking for PEs is the reason the test was done.
I do not disagree with the overall point though that the additional PEs identified may represent overdiagnosis (https://ebm.bmj.com/content/23/1/1).
Christopher F, I agree and take you point that 'incidental' is in the eye of the beholder. There is no standard definition though and the term is tossed around a lot. I typically refer to incidental in this context as a PE for which the treatment (anticoagulation) is more harmful than the disease- though as you point out - smart people might see it differently. If it explains the symptom - it may not be incidental - just not dangerous.
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Christopher F. - September 20, 2020 7:46 AM
"This group is probably just diagnosing more incidental PEs and might be causing net harm"
While I appreciate that the point here was to raise the question of the clinical significance of the additional PEs identified, a true "incidental finding" would usually be finding something you weren't looking for with the test you ordered. Finding even a small PE on a CTPA in my mind would not fairly be called an incidental finding since looking for PEs is the reason the test was done.
I do not disagree with the overall point though that the additional PEs identified may represent overdiagnosis (https://ebm.bmj.com/content/23/1/1).
Mike M. - September 24, 2020 4:02 PM
Christopher F, I agree and take you point that 'incidental' is in the eye of the beholder. There is no standard definition though and the term is tossed around a lot. I typically refer to incidental in this context as a PE for which the treatment (anticoagulation) is more harmful than the disease- though as you point out - smart people might see it differently. If it explains the symptom - it may not be incidental - just not dangerous.