I recently released a podcast with Dr Casey Parker on his brilliant Broomedocs website. This podcast was a preview to an article I’m writing that I’m hoping to have published next year on how I think we need to change our approach, based on the latest evidence, to the investigation of patients who are low risk for PE.

The podcast was published in 2 parts – available here:

PE Prognostication – Part 1

PE Prognostication – Part 2

The current approach to PE investigation is based on several unproven beliefs:

1. That untreated PE has a high mortality

2. That CTPA has an exceedingly low risk of harm

3. That CTPA is accurate at diagnosing PE

4. That if we diagnose PE we can significantly reduce a patient’s risk of death by treating them with anticoagulation.

In the podcast we expose these beliefs for what they are – unproven myths! In contrast, there is reasonable data to suggest our current approach to the investigation of patients at low risk of PE is causing more harm than benefit to patients. I propose a “New Approach” to low risk patients.

Twitter was a buzz with comments and feedback. Then Dr Scott Weingart, famous as the author of the truly excellent Emcrit podcasts, issued a podcast response agreeing with some concepts but challenging many that has since been released on Broomedocs entitled Weingart Weighs In.

In response to this I have today released a final podcast with Casey entitled Senthi Strikes Back to address all of Scott’s concerns and more.

All in all it makes for some really interesting debate and discussion! Furthermore through the discussion, we demonstrated the amazing power of the FOAM online world – including blogs, podcasts, twitter and all the followers and respondents – at helping provide important peer review. In the final podcast, we discuss how my suggested New Approach has been amended thanks to this excellent and relatively new FOAM peer review process.

Dr Anand Senthi