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Pulmonary embolism guidelines: will they work?
  1. A C Miller1,
  2. D A R Boldy2
  1. 1Chairman, BTS Pulmonary Embolism Working Party
  2. 2Chairman, BTS Standards of Care Committee
  1. Correspondence to:
    Dr A C Miller, Mayday Hospital, Croydon CR7 7YE, UK;
    andrew.miller{at}mayday.nhs.uk

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Updated guidelines on the management of suspected acute pulmonary embolism are published in this issue of Thorax. CT pulmonary angiography has become the central imaging investigation in the diagnosis of pulmonary embolism, but it is important that its use is carefully controlled to avoid unnecessary investigations in overworked radiology departments.

Two years ago several members of the British Thoracic Society independently suggested that, in the light of recent publications, the Standards of Care Committee should update their 1997 advice on suspected acute pulmonary embolism (PE). This issue of Thorax contains the results of this endeavour, with evidence sufficiently robust now to allow these to be called guidelines (see pp 470–83). Those familiar with the previous publication, to which the new document frequently refers, will recognise that the same basic structure has been used.

Previously, the main recommended option in the face of a non-diagnostic ventilation-perfusion (V/Q) scan was pulmonary angiography, an invasive test that was little used before and probably little …

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