By Alisdair Stirling
GPs using a decision rule - as well as a traditional visual assessment - can safely distinguish patients with and without deep vein thrombosis and reduce unnecessary referrals, a new study suggests.
Researchers tested the Oudega rule - an eight-point tool for spotting a DVT - in a group of 300 Dutch GPs seeing 1028 patients with suspected DVT.
A DVT was observed in 136 patients. Both the visual assessment and use of the clinical decision rule had good discriminative power.
Some 79% of patients without a DVT were referred for ultrasound in the GP assessment group, compared with 51% when using the rule.
Lead author Dr Geert-Jan Geersing, a GP at the University Medical Center in Utrecht said: ‘Clinical judgement alone often leads GPs to overestimating the actual DVT risk and subsequently results in more unnecessary referrals for compression ultrasonography in a large group of patients.'
BJGP 2010;60:742-748
