Real-time ultrasonography for the diagnosis of lower extremity deep venous thrombosis. The wave of the future?

We systematically reviewed 15 articles from the English-language medical literature, since 1977, which compared real-time ultrasonography with venography for the diagnosis of deep venous thrombosis (DVT) of the lower extremity. The studies varied in size (11 to 854 patients) and in compliance with methodologic standards for diagnostic test research. None of the studies attempted to establish the reliability of the test, nor did they provide sufficient clinical information about the patients; only 4 avoided biases associated with ordering and interpreting the tests. The 15 studies used similar techniques for the ultrasonographic examination, similar criteria for interpreting the test results, and reached similar conclusions. Although for all DVT the sensitivity varied from 0.78 to 1.00 and specificity from 0.78 to 1.00; for femoral and popliteal vein DVT the mean sensitivity was 0.96 (range, 0.92 to 1.00) and the mean specificity was 0.99 (range, 0.96 to 1.00). In addition, useful diagnostic information