The Measurement of Exercise Tolerance before Surgery (METS) trial has both raised, and answered, complicated questions. In the immediate wake of EBPOM 2018, this conversation explores some of the deeper issues and big take home moments from the trial. How will it change practice? Will it alter the use of the Duke Activity Status Index (DASI) for example? Cardiopulmonary Exercise Testing (CPET) clearly predicts major complications and is more predictive than the comparators. Why is this not clear in the abstract? Why is there an obsession with major cardiac events when they are rare?

Presented by Monty Mythen and Desiree Chappell with their guest Professor Mike Grocott of Southampton University and a lead investigator in the METS trial and an author of the paper.