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The Journal for Vascular Ultrasound 28(3):145–146, 2004 The Diagnosis of DVT: Are We Using an Evidence Based Approach? Mark H. Meissner, MD Introduction tomatic patients with two negative ultrasound exami- 1,3 nations 5–7 days apart has proven safe. Unfortunately, serial ultrasound evaluation is in- Venous duplex ultrasonography has become the convenient, expensive, and time consuming. Approxi- most widely used diagnostic modality for the exclu- mately 95% of follow-up studies will be negative. The sion of acute deep venous thrombosis (DVT). How- ability to exclude a lower extremity DVT on the basis ever, such studies are performed in a variety of diag- of a single ultrasound examination that includes the nostic settings with diverse clinical protocols, and it is calf veins would be optimal. Although the diagnostic important to recognize the steps involved in validat- accuracy of ultrasound in the detection of isolated calf ing a diagnostic test and the limitations they impose vein thrombosis is less than for proximal venous on the use of any particular strategy. First, establishing thrombosis, it is highly dependent on the technical the sensitivity and specificity of any new diagnostic adequacy of the study. For technically adequate stud- test requires comparison with a validated,
Journal for Vascular Ultrasound – SAGE
Published: Sep 1, 2004
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