alexa Limited value of patient history and physical examination in diagnosing deep vein thrombosis in primary care.
Biomedical Sciences

Biomedical Sciences

Journal of Biomedical Engineering and Medical Devices

Author(s): Oudega R, Moons KG, Hoes AW

Abstract Share this page

Abstract BACKGROUND: Properly ruling in or out deep vein thrombosis (DVT) is important because of the risk of developing pulmonary embolism if untreated and the risk of bleeding when treated with anticoagulants. In primary care, the diagnosis in suspected DVT is non-specific and the physician has to decide which patients to refer for further diagnostic work-up on the basis of patient history and physical examination alone. OBJECTIVE: To quantify which (combination of) items from patient history and physical examination contribute to the diagnosis of DVT in primary care. METHODS: A cross-sectional study design was chosen and the setting was all primary care physicians adherent to three local hospitals. 1325 consecutive patients consulting their primary care physician with symptoms suggestive of DVT were included. RESULTS: We studied 1325 patients with suspected DVT. The prevalence of thrombosis (assessed by means of compression ultrasonography) in these patients was 29\%. Multivariate regression analysis of 17 candidate predictors resulted in nine independent predictors of DVT: male gender, duration of symptoms, malignancy, immobilization, leg trauma, pain when walking, oedema, calf circumference and dilated veins. The predictive value of the combination of the nine independent variables was low, reflected in the ROC area (as a combination of the sensitivity and specificity) of this model of 0.68. The low discriminative value was also exhibited in the numbers of DVT in the different risk categories. For example, in the low-risk group, the probability of DVT was still 15\%. The diagnostic performance of patient history and physical examination was similar (and thus poor) in all clinically relevant subgroups. CONCLUSION: Patient history and physical examination in patients suspected of DVT are of limited value for the primary care setting to identify patients with a low or high probability of DVT and thus in the decision to refer for further diagnostic work-up. This article was published in Fam Pract and referenced in Journal of Biomedical Engineering and Medical Devices

Relevant Expert PPTs

Relevant Speaker PPTs

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords