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- W4366992713 abstract "Deep vein thrombosis (DVT) affects approximately 1 to 2 per 1000 people annually [ [1] Heit J.A. Silverstein M.D. Mohr D.N. Petterson T.M. Lohse C.M. O’Fallon W.M. Melton III, L.J. The epidemiology of venous thromboembolism in the community. Thromb Haemost. 2001; 86: 452-463 Crossref PubMed Scopus (542) Google Scholar ], carrying high mortality due to risk of pulmonary embolism and morbidity from postthrombotic syndrome [ [2] Kearon C. Diagnosis of suspected venous thromboembolism. Hematology Am Soc Hematol Educ Program. 2016; 2016: 397-403 Crossref PubMed Scopus (29) Google Scholar ]. As clinical signs can be unreliable, validated clinical risk tools, such as the Wells score, are used to guide diagnostic evaluation through risk-stratifying by clinical pretest probability [ [3] Wells P.S. Anderson D.R. Bormanis J. Guy F. Mitchell M. Gray L. Clement C. Robinson K.S. Lewandowski B. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet. 1997; 350: 1795-1798 Abstract Full Text Full Text PDF PubMed Scopus (1011) Google Scholar , [4] Wells P.S. Anderson D.R. Rodger M. Forgie M. Kearon C. Dreyer J. Kovacs G. Mitchell M. Lewandowski B. Kovacs M.J. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003; 349: 1227-1235 Crossref PubMed Scopus (1188) Google Scholar ]. In routine practice, high-risk patients proceed directly to ultrasonography, whilst lower-risk patients require a quantitative D-dimer measurement over a certain threshold to warrant imaging. However, despite the widespread use of this algorithm, the large majority of patients require ultrasonography; yet, only 10% to 15% of patients referred with a suspected DVT are actually found to have this diagnosis [ [5] Büller H.R. Ten Cate-Hoek A.J. Hoes A.W. Joore M.A. Moons K.G.M. Oudega R. Prins M.H. Stoffers H.E.J.H. Toll D.B. van der Velde E.F. van Weert H.C.P.M. AMUSE (Amsterdam Maastricht Utrecht Study on thromboEmbolism) Investigators. Safely ruling out deep venous thrombosis in primary care. Ann Intern Med. 2009; 150: 229-235 Crossref PubMed Scopus (103) Google Scholar ]. This drives up cost and anxiety from overinvestigation and risks of unnecessary short-term anticoagulation when testing is delayed." @default.
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- W4366992713 date "2023-08-01" @default.
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- W4366992713 title "Diagnosis of deep vein thrombosis using an adjusted clinical probability scoring: supportive evidence for a change in clinical practices" @default.
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- W4366992713 doi "https://doi.org/10.1016/j.jtha.2023.04.016" @default.
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