Key result
The combination of a low clinical pre-test score and a D-dimer level <400 units had a negative predictive value of 100% for excluding deep venous thrombosis, safely reducing the need for Doppler ultrasound by 23%.
Why the study?
Does a diagnostic algorithm combining clinical pre-test probability, D-dimer, and serial Doppler ultrasonography safely exclude deep venous thrombosis in patients with suspected DVT?
Population
194 patients with suspected deep venous thrombosis at a district general hospital in England. Mean age 57.6…
Design
Cohort, Assessors were blind to each other's assessment.
Follow-up
6 months
Authors
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May reduce unnecessary ultrasounds in low-risk patients with negative D-dimer; leaves open prospective validation before practice change.
Cohort (n=194)
Single-blind
No
Does a diagnostic algorithm combining clinical pre-test probability, D-dimer, and serial Doppler ultrasonography safely exclude deep venous thrombosis in patients with suspected DVT?
A diagnostic algorithm combining a low clinical pre-test score and a negative D-dimer safely and reliably excludes DVT, potentially reducing the need for Doppler ultrasonography by 23%.
Walsh et al. (2002) conducted a cohort in Suspected deep venous thrombosis (n=194). Diagnostic algorithm (clinical assessment and D-dimer) was evaluated on Negative predictive value of a low clinical pre-test score combined with D-dimer <400 units for excluding deep venous thrombosis (95% CI 98-103). The combination of a low clinical pre-test score and a D-dimer level <400 units had a negative predictive value of 100% for excluding deep venous thrombosis, safely reducing the need for Doppler ultrasound by 23%.
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