GPs rule in a diagnosis of DVT

DEEP venous thrombosis (DVT) can be difficult to detect, so scoring systems have been introduced in an attempt to improve diagnosis. Dutch researchers have now tested these clinical decision rules against GPs’ clinical judgement.

The study involved 300 GPs. When a patient presented with suspicious symptoms they estimated the probability of a DVT. The GPs also used a decision rule to score the symptoms and carried out a D-dimer test. Patients with a high score were referred for ultrasound scans.  

DVT was suspected in 1086 patients. They had an average age of 58 years and 63% were female.

The GPs referred most of the suspected cases for imaging. If they had followed the clinical decision rules only 51% of the patients would have been investigated.

The patients were followed up for 90 days. During this time a thrombosis was confirmed in 14% of the evaluable patients.

Depending on the probability estimate, the GPs did