What is the clinical evidence from this study?

Study design: Observational. Population: Deep vein thrombosis (n=102). Intervention: 125I Fibrinogen Uptake Test vs. Phlebography. Primary outcome: Correct diagnosis of established venous thrombosis.

What question did this study set out to answer?

To evaluate the diagnostic accuracy and clinical reliability of the 125I fibrinogen uptake test compared with phlebography in patients with suspected established deep vein thrombosis.

November 6, 1971BMJOpen Access

Diagnosis of Established Deep Vein Thrombosis with the 125I Fibrinogen Uptake Test

View Full Paper

Ask AI

Bookmark

Key result

The 125I fibrinogen uptake test correctly diagnosed deep vein thrombosis in 78% of legs with confirmed thrombus, with a 10% false-negative rate across 195 examined legs.

Why the study?

Does the 125I-fibrinogen uptake test accurately diagnose established deep vein thrombosis compared to phlebography in patients with suspected DVT or pulmonary embolism?

Population

102 patients with clinical signs indicating a possible diagnosis of deep vein thrombosis or pulmonary embolus.

Comparison

125I-Fibrinogen Uptake Test vs Ascending lower limb phlebography

Design

Cohort

Follow-up

18 to 28 hours (up to 5 days)

Authors

NBN. L. BrowseMayo Clinic WCW F ClaphamSt Thomas' Hospital DCD. N. CroftSt Thomas' Hospital

Discussion

Member takes

Implication

Supports moderate accuracy of 125I fibrinogen uptake for DVT diagnosis; leaves open its role versus modern imaging in prospective studies.

Key Points

To evaluate the diagnostic accuracy and clinical reliability of the 125I fibrinogen uptake test compared with phlebography in patients with suspected established deep vein thrombosis.
Evaluated 102 patients presenting with clinical signs of deep vein thrombosis across 195 legs using both the fibrinogen uptake test and phlebography.
Assessed the influence of symptom duration, anticoagulant administration, leg swelling, and thrombus age on diagnostic accuracy.
The fibrinogen uptake test yielded a correct diagnosis in 78% of the 85 legs confirmed to have thrombi by phlebography, with 19 false-negative results (10%) among the 195 total legs examined.
Diagnostic accuracy was not influenced by symptom duration, anticoagulant therapy, or mild leg swelling, whereas thrombi older than 11 days on phlebography showed an increased rate of false-negative findings.

Study Design

Type

Observational (n=102)

Structured PICO

Does the 125I-fibrinogen uptake test accurately diagnose established deep vein thrombosis compared to phlebography in patients with suspected DVT or pulmonary embolism?

Population

102 patients with clinical signs of possible deep vein thrombosis evaluated to assess the reliability of the 125I fibrinogen uptake test compared to phlebography.

Exposure

125I-Fibrinogen Uptake Test (1 mg of fibrinogen labelled with 100 uCi of 125I injected intravenously, examined 18-28 hours later)

Comparator

Ascending lower limb phlebography (reference standard)

Outcome

Diagnostic accuracy (agreement, false-positive, and false-negative rates) of the 125I-fibrinogen uptake test compared to phlebographysurrogate

The 125I-fibrinogen uptake test is an accurate method for detecting established deep leg vein thrombosis, even in patients on anticoagulants, though accuracy decreases for older thrombi.

Limitations

Very old thrombus (more than 11 days old) was associated with an increased false-negative rate.
Increased false-negative rate with very old thrombus (>11 days old)
Gross leg oedema and superficial inflammatory lesions can cause false-positive tests

Cite This Study

Browse et al. (1971) conducted an observational in Deep vein thrombosis (n=102). 125I Fibrinogen Uptake Test vs. Phlebography was evaluated on Correct diagnosis of established venous thrombosis. The 125I fibrinogen uptake test correctly diagnosed deep vein thrombosis in 78% of legs with confirmed thrombus, with a 10% false-negative rate across 195 examined legs.

synapsesocial.com/papers/6a940702bbea1c735e92ce0c https://doi.org/10.1136/bmj.4.5783.325

View Full Paper

Ask AI

Bookmark

Implication

Supports moderate accuracy of 125I fibrinogen uptake for DVT diagnosis; leaves open its role versus modern imaging in prospective studies.

Diagnosis of Established Deep Vein Thrombosis with the 125I Fibrinogen Uptake Test

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Diagnosis of Established Deep Vein Thrombosis with the 125I Fibrinogen Uptake Test

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider