Journal ArticleDOI
Value of assessment of pretest probability of deep-vein thrombosis in clinical management
Philip S. Wells,David Anderson,Janis Bormanis,Fred Guy,Michael Mitchell,Lisa Gray,Cathy Clement,K Sue Robinson,Bernard Lewandowski +8 more
TLDR
Management of patients with suspected deep-vein thrombosis based on clinical probability and ultrasound of the proximal deep veins is safe and feasible and the need for serial ultrasound testing is reduced and the rate of false-negative or false-positive ultrasound studies is reduced.About:
This article is published in The Lancet.The article was published on 1997-12-20. It has received 1125 citations till now. The article focuses on the topics: Venography & Pre- and post-test probability.read more
Citations
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Journal ArticleDOI
Evaluation of D-Dimer in the Diagnosis of Suspected Deep-Vein Thrombosis
Philip S. Wells,David Anderson,Marc A. Rodger,Melissa A. Forgie,Clive Kearon,Jonathan Dreyer,George Kovacs,Michael Mitchell,Bernard Lewandowski,Michael J. Kovacs +9 more
TL;DR: Deep-vein thrombosis can be ruled out in a patient who is judged clinically unlikely to have deep-veIn thromBosis and who has a negative D-dimer test, and ultrasound testing can be safely omitted in such patients.
Journal ArticleDOI
Prognosis and prognostic research: application and impact of prognostic models in clinical practice
TL;DR: An accurate prognostic model is of no benefit if it is not generalisable or doesn’t change behaviour.
Journal ArticleDOI
Pulmonary embolism and deep vein thrombosis
TL;DR: Pulmonary embolism and deep vein thrombosis of the legs is discussed and several novel oral anticoagulant drugs are in development, which could replace vitamin K antagonists and heparins in many patients.
Journal ArticleDOI
Non-invasive diagnosis of venous thromboembolism in outpatients
Arnaud Perrier,Sylvie Desmarais,M J Miron,P. De Moerloose,Raymond Lepage,Daniel O. Slosman,Dominique Didier,Pierre Unger,Jean-Victor Patenaude,Henri Bounameaux +9 more
TL;DR: A diagnostic strategy combining clinical assessment, D-dimer, ultrasonography, and lung scan gave a non-invasive diagnosis in the vast majority of outpatients with suspected venous thromboembolism, and appeared to be safe.
Journal ArticleDOI
Translating Clinical Research into Clinical Practice: Impact of Using Prediction Rules To Make Decisions
TL;DR: A fifth level of evidence is proposed because it is believed that broad verification of a prediction rule's clinical impact is no less important than that of the prediction rule on which it is based, and progressive evidentiary standards emphasize that a prediction rules rises to the level of a decision rule only if clinicians use its predictions to help make decisions for patients.
References
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Journal ArticleDOI
Detection of deep-vein thrombosis by real-time B-mode ultrasonography
Anthonie W. A. Lensing,Paolo Prandoni,D. P. M. Brandjes,P.M. Huisman,M Vigo,G Tomasella,J Krekt,J. Wouter ten Cate,Menno V. Huisman,H. R. Büller +9 more
TL;DR: It is concluded that ultrasonography with the single criterion of vein compressibility is a highly accurate, simple, objective, and reproducible noninvasive method for detecting proximal-vein thrombosis in outpatients with clinically suspected deep-venous thromBosis.
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Roentgen diagnosis of venous thrombosis in the leg
Keith Rabinov,Sven Paulin +1 more
TL;DR: In technique for lower extremity phlebography the patient is in a semi-upright position, supporting his weight on the contralateral foot, and the dye injection is made into a dorsal pedal vein and no tourniquet is used.
Journal ArticleDOI
Accuracy of clinical assessment of deep-vein thrombosis
Philip S. Wells,Jack Hirsh,D. R. Anderson,A. W. A. Lensing,Gary Foster,Clive Kearon,Jeffrey I. Weitz,Robert D'Ovidio,Alberto Cogo,Paolo Prandoni,Antonio Girolami,Jeffrey S. Ginsberg +11 more
TL;DR: Use of the clinical model combined with venous ultrasonography would decrease the number of false positive and negative diagnosis if venography were done when the ultrasound result and pretest probability were discordant.
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Need for long-term anticoagulant treatment in symptomatic calf-vein thrombosis.
TL;DR: The findings indicate that oral anticoagulants should be given to all patients with thrombi that produce symptoms and that treatment for 3 months seems to be sufficient.
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Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study
Alberto Cogo,Anthonie W. A. Lensing,Maria M. W. Koopman,Franco Piovella,Sergio Siragusa,Philip S. Wells,Sabina Villalta,Harry R. Buller,Alexander G.G. Turpie,Paolo Prandoni +9 more
TL;DR: It is safe to withhold anticoagulant treatment from patients with suspected deep vein thrombosis who have normal results on compression ultrasonography on presentation and on a single repeat test 1 week later with the simplified compression ultrasound strategy.