Comparison of four clinical prediction scores for the diagnosis of lower limb deep venous thrombosis in outpatients

Constans, J.; Boutinet, C.; Salmi, Louis‐Rachid; Saby, J.C.; Nelzy, M.L.; Baudouin, P; Sampoux, F.; Marchand, J.M.; Boutami, C; Dehant, Véronique; Pulci, Stéphane; Gauthier, Jean Paul; Cacareigt-Bourdenx, Véronique; Barcat, D.; Conri, C.

doi:10.1016/s0002-9343(03)00432-7

Cited by 45 publications

(47 citation statements)

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“…56 clinical prediction or pretest probability estimates (structured and based on specifi c criteria or unstructured and empirical) are able to stratify patients into groups according to their probability of DVT. 56 Several structured scoring systems have been developed 10,31,32,[56][57][58][59][60] ; the most well studied is the Wells score. 6,10,31,56 This rule incorporates signs, symptoms, and risk factors for VTE to categorize patients as having a low, moderate, or high probability of DVT, 31 with a prevalence of DVT of 5.0% (95% CI, 4%-8%), 17% (95% CI, 13%-23%), and 53% (95% CI, 44%-61%), respectively.…”

Section: Diagnosis Of Suspected First Lower Extremity Dvtmentioning

confidence: 99%

Diagnosis of DVT

Bates

Jaeschke

Stevens

et al. 2012

Chest

566

192

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Section: Diagnosis Of Suspected First Lower Extremity Dvtmentioning

confidence: 99%

Diagnosis of DVT

Bates

Jaeschke

Stevens

et al. 2012

Chest

566

192

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“…Constans et al 12 created both a 6-item screening tool to detect both proximal and distal DVTs known as the St Andre Score, as well as a 6-item outpatient DVT screening tool to detect proximal and distal DVTs known as the New Ambulatory Score (Table 5). 11 The 3 hospital-based scoring systems had little agreement, but they all increased early detection of DVTs within the hospital setting according to their users. 11 When all 4 DVT screening tools were used on an outpatient population, the New Ambulatory Score was better at discriminating patients with DVTs than the Kahn Score and the St Andre Score, but gave similar results as the Wells Score.…”

Section: Physical Therapy Considerations: Clinical Prediction Rulesmentioning

confidence: 99%

“…11 The 3 hospital-based scoring systems had little agreement, but they all increased early detection of DVTs within the hospital setting according to their users. 11 When all 4 DVT screening tools were used on an outpatient population, the New Ambulatory Score was better at discriminating patients with DVTs than the Kahn Score and the St Andre Score, but gave similar results as the Wells Score.…”

Section: Physical Therapy Considerations: Clinical Prediction Rulesmentioning

confidence: 99%

“…Three different researchers published 4 separate standardized screening tools to diagnose DVTs. 11,12,30,56 All of these screening tools are solely based on the findings of the history and physical exam. 11,12,30,56 Two of the DVT screening tests are to be used exclusively for inpatients residing in hospital settings,…”

Section: Physical Therapy Considerations: Clinical Prediction Rulesmentioning

confidence: 99%

“…11 Wells et al [54][55][56][57] created a 9-item screening tool to detect proximal thrombosis known as the Wells Score. Kahn et al 30 developed a 4-item screening tool to detect proximal thrombosis known as the Kahn Score.…”

Section: Physical Therapy Considerations: Clinical Prediction Rulesmentioning

confidence: 99%

See 2 more Smart Citations

Deep Vein Thrombosis in an Athletic Military Cadet

Fink

Stoneman²

2006

J Orthop Sports Phys Ther

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Study Design: Resident's case problem. Background: A 21-year-old healthy athletic male military cadet with complaint of worsening diffuse left knee pain was evaluated 4 days after onset. The knee pain began 2 hours after completing a long car trip, worsened over the subsequent 3 days, and became almost unbearable during the return trip. The patient reported constant pain, limited knee motion, and difficulty ambulating. In addition, he was unable to perform physical military training or attend academic classes due to the severe left knee pain. Past medical history revealed a mild left lateral calf strain 2 1 ⁄2 weeks prior, which completely resolved within 24 hours of onset. Diagnosis: Our physical examination led us to either monoarticular arthritis, pseudothrombophlebitis (ruptured Baker's cyst), or a lower leg deep vein thrombosis (DVT) as the cause of knee pain. Diagnostic imaging of this patient revealed a left superficial femoral vein thrombosis and popliteal DVT, with bilateral pulmonary emboli (PE). Discussion: A systematic differential diagnosis was undertaken to rule out a potentially fatal DVT diagnosis as the cause of knee pain, despite minimal DVT risk factors. The physical therapist in a direct-access setting must ensure timely evaluation and referral of a suspected DVT, even when patient demographics cause the practitioner to question the likelihood of this diagnosis. The physical examination findings, clinical suspicion, and established clinical prediction rules can accurately dictate the appropriate referral action necessary.

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Venous Disease and Pulmonary Embolism

Foley

Moneta

2008

Surgery

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Comparison of four clinical prediction scores for the diagnosis of lower limb deep venous thrombosis in outpatients

Cited by 45 publications

References 24 publications

Diagnosis of DVT

Diagnosis of DVT

Deep Vein Thrombosis in an Athletic Military Cadet

Venous Disease and Pulmonary Embolism

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