Thursday, August 05, 2010
Another review on the diagnosis and treatment of pulmonary embolism
I've linked to quite a few PE reviews, here, probably to most that have been published over the past few years. A disturbing non-evidence based trend I've noted in these reviews is an increasing emphasis on CT over V/Q scanning as the initial diagnostic strategy of choice. Some of the more recent reviews clearly state that CT scanning is the modality of choice. This latest one (an otherwise excellent review) doesn't even mention V/Q scanning. The trend is based solely on popular belief, there being no evidence to support it. These reviews are propagating a popular myth. I have not data to back this up, and I'd like to see it systematically studied, but I suspect this is keeping the nephrologists busy in hospitals.