Perioperative Exercise Testing & Training Society (POETTS)


POETTS was established in 2016  to promote standardised practice through consensus guidelines and standardised education and training and to conduct and disseminate audit, quality improvement and research in the field of perioperative exercise testing and training.  With the advent of multimodal prehabilitation (optimising metabolic and psychological fitness alongside physical fitness), the remit of POETTS has expanded to include physical, nutritional and psychological optimisation prior to surgery or other treatments such as chemotherapy for cancer.


POETTS has developed standardised training for perioperative cardiopulmonary exercise testing (POETTS) including an accreditation process which involves a period of supervised practice and reporting under the mentoring of a POETTS accredited physician. We deliver a standardised course twice a year in London, which we aim to deliver online this Autumn.  We run a one day conference annually as part of the Evidence Based Perioperative Medicine conference


POETTS have published consensus clinical practice guidelines for the performance of perioperative cardiopulmonary exercise testing which include staffing, indications, contraindications and physiological interpretation (Levett et al, BJA 2018).  We have also provided guidance for the use of CPET during the COVID-19 pandemic.  These can be accessed by the website.  We are currently producing physical activity/exercise advice for patients self isolating prior to elective surgery.


POETTS has been recognised as an academic society by the National Institute of Academic Anaesthesia at the Royal College of Anaesthetists.  We have supported multicentre collaborative research projects in aneurysm surgery (Carlisle Anaesth 2015); colorectal surgery (West BJS 2016), oesphagectomy (in progress), validation of interpretation (Abbot BJA 2018); gender differences in normal values (Thomas Periop Med, 2020) and surveys of practice (Reeves Periop Med 2020) and practice during Covid 19 (Mclelland (in progress)).  Our planned projects for 2020 include:  Validation of the Duke Activity Survey for the estimation of VO2peak (lead: Prof Denny Levett, Southampton); prospective evaluation of the Carlisle aneurysm mortality model (Lead: John Carlisle, Torquay).  We are working to establish a database at the Royal College of Anaesthetists for prospective data collection of perioperative exercise testing and prehabilitation data.  If you would like to contribute to any of these projects, please get in touch.

Get in touch

You can join POETTS, find details of POETTS courses and accreditation on our website and POETTS accredited clinicians and mentors via the website.  


POETTS collaborative research papers and guidelines:

Levett DZH, Jack S, Swart M, et al. Perioperative cardiopulmonary exercise testing (CPET): consensus clinical guidelines on indications, organization, conduct, and physiological interpretation. Br J Anaesth. 2018;120(3):484-500. doi:10.1016/j.bja.2017.10.020

Abbott TEF, Gooneratne M, McNeill J, et al. Inter-observer reliability of preoperative cardiopulmonary exercise test interpretation: a cross-sectional study. Br J Anaesth. 2018;120(3):475-483. doi:10.1016/j.bja.2017.11.071

Carlisle JB, Danjoux G, Kerr K, Snowden C, Swart M. Validation of long-term survival prediction for scheduled abdominal aortic aneurysm repair with an independent calculator using only pre-operative variables. Anaesthesia. 2015;70(6):654-665. doi:10.1111/anae.13061

West MA, Asher R, Browning M, et al. Validation of preoperative cardiopulmonary exercise testing-derived variables to predict in-hospital morbidity after major colorectal surgery. Br J Surg. 2016;103(6):744-752. doi:10.1002/bjs.10112

Thomas G, West MA, Browning M, et al. Why women are not small men: sex-related differences in perioperative cardiopulmonary exercise testing. Perioper Med (Lond). 2020;9:18. Published 2020 Jun 4. doi:10.1186/s13741-020-00148-2

Reeves T, Bates S, Sharp T, et al. Cardiopulmonary exercise testing (CPET) in the United Kingdom-a national survey of the structure, conduct, interpretation and funding [published correction appears in Perioper Med (Lond). 2018 May 4;7:8]. Perioper Med (Lond). 2018;7:2. Published 2018 Jan 26. doi:10.1186/s13741-017-0082-3