Podcast 184: Ruling out pulmonary embolism in primary care

Pulmonary embolism is a vexing problem in primary care: Does this patient have it? Can I send them home with reassurance? Should I refer them for further testing?

A Dutch group has evaluated the tests most likely to be available in the primary care setting — the various flavors of the Wells rules and the Geneva scores — against a panel of some 600 patients with suspected PE and known outcomes after referral and three months’ follow-up. They come down in favor of the Wells rule and simple D-dimer testing, but an editorialist in the BMJ offers a note of dissent.

Our interview with one of the study authors, Dr. Geert-Jan Geersing, sorts this all out.

[Running time: 13 minutes]

BMJ study (free)

BMJ editorial (subscription required)