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Updated: Sep 14, 2025

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
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Published on: June 2, 2015

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Validation of the ToDay, a simplified diagnostic algorithm for deep vein thrombosis

Sasha Sharma1, Linnea Soon2, Kerstin de Wit3

  • 1Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada.

Journal of Thrombosis and Haemostasis : JTH
|July 18, 2025
PubMed

Insights

The ToDay algorithm offers a safe and efficient way to diagnose deep vein thrombosis (DVT), reducing the need for ultrasounds. This simplified approach improves clinical practice adherence for DVT diagnosis.

Area of Science:

  • Medical Diagnostics
  • Clinical Decision Support
  • Thrombosis Research

Background:

  • Current deep vein thrombosis (DVT) diagnostic algorithms face low adherence due to complexity.
  • Simplified diagnostic strategies are crucial for improving clinical practice and accuracy.
  • The ToDay algorithm integrates physician assessment with D-dimer testing for a streamlined DVT diagnosis.

Purpose of the Study:

  • To validate the efficacy of the ToDay algorithm using existing data.
  • To assess the ToDay algorithm's performance in a real-world clinical setting.
  • To evaluate the algorithm's impact on diagnostic workflow and resource utilization.

Main Methods:

  • Retrospective analysis of data from the 4D study (NCT02038530).
  • The ToDay algorithm was applied, considering DVT likelihood and D-dimer levels (including age-adjusted thresholds).
  • Primary outcome: 90-day symptomatic venous thromboembolism (VTE); Secondary outcome: avoidance of ultrasound imaging.

Main Results:

  • The ToDay algorithm excluded DVT in 1334 patients, with a 0.75% VTE failure rate.
  • Deep vein thrombosis (DVT) was diagnosed in 10.9% (163/1497) of patients.
  • 38.6% of patients avoided the need for ultrasound imaging.

Conclusions:

  • The ToDay algorithm is a safe and effective alternative for DVT diagnosis, simplifying the process.
  • It significantly reduces the reliance on ultrasound imaging, enhancing efficiency in emergency settings.
  • Prospective validation is recommended prior to widespread clinical adoption of the ToDay algorithm.
Abstract

Keywords:
D-dimerdeep vein thrombosisdiagnosis

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