Abstract
Objective: To validate the predictive value of the Canadian clinical probability model for acute venous thrombosis, which, to the best of the authors' knowledge, has not been done in emergency department (ED) settings outside of Canada. Methods: Demographic and clinical information, rapid D-dimer testing, and venous ultrasound imaging were obtained among patients presenting with clinically suspected venous thrombosis at a university-affiliated ED. A diagnosis of deep venous thrombosis (DVT) was made based on venous ultrasound test results or objectively documented venous thromboembolism during a 12-week follow-up period. The probability of venous thrombosis was calculated using the Canadian clinical probability model. Results: Among 102 patients, 17 (17%) were diagnosed as having venous thrombosis initially or during the three-month follow-up period. The frequency of venous thrombosis among patients categorized as having high probability was 10 of 17 [59%, 95% confidence interval (95% CI) = 35% to 82%], 6 of 44 (14%, 95% CI = 4% to 24%) with intermediate probability, and 1 of 41 (2%, 95% CI = 0.1% to 11%) with low probability. This compares with respective values of 49%, 14%, and 3%, reported by Canadian researchers in an ED study. Forty-one of 102 (40%) patients had an alternate diagnosis as likely or more likely than venous thrombosis, but only three (7%, 95% CI = 2% to 18%) of these had venous thrombosis. Conclusions: Use of the Canadian probability model for DVT in this ED resulted in effective risk stratification, comparable to previously published results.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 561-566 |
| Number of pages | 6 |
| Journal | Academic Emergency Medicine |
| Volume | 9 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2002 |
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Keywords
- Acute venous thrombosis
- Clinical probability
- DVT
- Validation
ASJC Scopus subject areas
- Emergency Medicine
Cite this
Validation of the Canadian clinical probability model for acute venous thrombosis. / Shields, G. Patrick; Turnipseed, Samuel D; Panacek, Edward A; Melnikoff, Norman; Gosselin, Robert; White, Richard H.
In: Academic Emergency Medicine, Vol. 9, No. 6, 2002, p. 561-566.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Validation of the Canadian clinical probability model for acute venous thrombosis
AU - Shields, G. Patrick
AU - Turnipseed, Samuel D
AU - Panacek, Edward A
AU - Melnikoff, Norman
AU - Gosselin, Robert
AU - White, Richard H
PY - 2002
Y1 - 2002
N2 - Objective: To validate the predictive value of the Canadian clinical probability model for acute venous thrombosis, which, to the best of the authors' knowledge, has not been done in emergency department (ED) settings outside of Canada. Methods: Demographic and clinical information, rapid D-dimer testing, and venous ultrasound imaging were obtained among patients presenting with clinically suspected venous thrombosis at a university-affiliated ED. A diagnosis of deep venous thrombosis (DVT) was made based on venous ultrasound test results or objectively documented venous thromboembolism during a 12-week follow-up period. The probability of venous thrombosis was calculated using the Canadian clinical probability model. Results: Among 102 patients, 17 (17%) were diagnosed as having venous thrombosis initially or during the three-month follow-up period. The frequency of venous thrombosis among patients categorized as having high probability was 10 of 17 [59%, 95% confidence interval (95% CI) = 35% to 82%], 6 of 44 (14%, 95% CI = 4% to 24%) with intermediate probability, and 1 of 41 (2%, 95% CI = 0.1% to 11%) with low probability. This compares with respective values of 49%, 14%, and 3%, reported by Canadian researchers in an ED study. Forty-one of 102 (40%) patients had an alternate diagnosis as likely or more likely than venous thrombosis, but only three (7%, 95% CI = 2% to 18%) of these had venous thrombosis. Conclusions: Use of the Canadian probability model for DVT in this ED resulted in effective risk stratification, comparable to previously published results.
AB - Objective: To validate the predictive value of the Canadian clinical probability model for acute venous thrombosis, which, to the best of the authors' knowledge, has not been done in emergency department (ED) settings outside of Canada. Methods: Demographic and clinical information, rapid D-dimer testing, and venous ultrasound imaging were obtained among patients presenting with clinically suspected venous thrombosis at a university-affiliated ED. A diagnosis of deep venous thrombosis (DVT) was made based on venous ultrasound test results or objectively documented venous thromboembolism during a 12-week follow-up period. The probability of venous thrombosis was calculated using the Canadian clinical probability model. Results: Among 102 patients, 17 (17%) were diagnosed as having venous thrombosis initially or during the three-month follow-up period. The frequency of venous thrombosis among patients categorized as having high probability was 10 of 17 [59%, 95% confidence interval (95% CI) = 35% to 82%], 6 of 44 (14%, 95% CI = 4% to 24%) with intermediate probability, and 1 of 41 (2%, 95% CI = 0.1% to 11%) with low probability. This compares with respective values of 49%, 14%, and 3%, reported by Canadian researchers in an ED study. Forty-one of 102 (40%) patients had an alternate diagnosis as likely or more likely than venous thrombosis, but only three (7%, 95% CI = 2% to 18%) of these had venous thrombosis. Conclusions: Use of the Canadian probability model for DVT in this ED resulted in effective risk stratification, comparable to previously published results.
KW - Acute venous thrombosis
KW - Clinical probability
KW - DVT
KW - Validation
UR - http://www.scopus.com/inward/record.url?scp=0036268919&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036268919&partnerID=8YFLogxK
U2 - 10.1197/aemj.9.6.561
DO - 10.1197/aemj.9.6.561
M3 - Article
VL - 9
SP - 561
EP - 566
JO - Academic Emergency Medicine
JF - Academic Emergency Medicine
SN - 1069-6563
IS - 6
ER -