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A DIAGNOSTIC TOOL TO SAFELY EXCLUDE DVT IN PRIMARY CARE: A VALIDATION STUDY
Abstract number: P-W-532
Toll1 D.B., Oudega1 R., Hoes1 A.W., Moons1 K.G.M.
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
How-to-cite Toll DB, Oudega R, Hoes AW, Moons KGM. A DIAGNOSTIC TOOL TO SAFELY EXCLUDE DVT IN PRIMARY CARE: A VALIDATION STUDY. J Thromb Haemost 2007; 5 Supplement 2: P-W-532
Abstract
Introduction: We recently developed a simple diagnostic rule (including 7 history and physical findings plus D-dimer assay result) to safely exclude the presence of deep vein thrombosis (DVT) without the need for referral in primary care patients suspected of DVT. When applied to new patients, the performance of any diagnostic prediction rule tends to be lower than expected based on the original study results. Therefore, rules first need to be tested on their applicability in another primary care population before their implementation in daily practice. This was the aim of this study.
Methods: We prospectively identified 532 primary care patients with suspicion of DVT. The rule items were obtained from each patient as well as the result of compression ultrasonography (CUS) serving as the reference ("gold") standard. The rule was dichotomised at the previously determined threshold of <= 3 (very low risk of DVT) versus >= 4 (increased risk of DVT). The accuracy of the rule was primarily quantified by its ability to safely exclude DVT (percentage missed DVT cases among very low risk patients).
Results: The rule designated 21% of all patients as very low risk of having DVT. This was 23% in the development population. None of these very low risk patients had DVT, compared to 0.7% in the development population.
Conclusions: The rule appears to be a safe diagnostic tool for excluding DVT in patients suspected of DVT in primary care, leading to a substantial reduction of unnecessary patient referrals to secondary care and consequently of patient burden.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
Session Details
| Date: |
01/08/2007
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| Time: |
00:00-00:00
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| Session name: |
XXIst ISTH Congress |
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| Location: |
Oxford, UK |
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