August 2020

Abstract 12: Variability in practice patterns in diagnosing PE

EMA 2020 August26 Chapters

  1. Introduction2:58
  2. Ultra Summary27:44
  3. Time To Talk A Little Nerdy: Shared Decision-Making23:22
  4. Farewell2:58
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Christopher F. -

"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. -

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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EMA 2020 August Full episode audio for MD edition 187:55 min - 90 MB - M4AEMA 2020 August - All Abstracts PDF 375 KB - PDFEMA 2020 August - CME Questions 43 KB - PDFEMA 2020 August MP3s 156 MB - ZIPTime To Talk A Little Nerdy: Shared Decision-Making 251 KB - PDF

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