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Upper extremity post-thrombotic syndrome score: consensus results from an international Delphi study
Tjep Hoedemakers1, Eline S van Hattum1, Bart-Jeroen Petri1
1Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
Journal of Thrombosis and Haemostasis : JTH
|September 19, 2025
Summary
Experts reached consensus on definitions for diagnosing upper extremity post-thrombotic syndrome (UE-PTS). This work aims to standardize UE-PTS score application for better patient outcomes.
Area of Science:
- Vascular Medicine
- Clinical Diagnostics
- Medical Consensus Building
Background:
- Upper extremity post-thrombotic syndrome (UE-PTS) lacks a definitive diagnostic standard.
- Previous Delphi consensus studies aimed to create a UE-PTS diagnostic and classification score.
Purpose of the Study:
- To achieve expert consensus on the definitions of individual components within the UE-PTS score.
- To facilitate consistent and reliable application of the UE-PTS score in clinical settings.
Main Methods:
- A Delphi approach involving 53 invited experts was employed.
- Definitions were co-developed by a steering committee and patients, refined through 3 expert rating rounds.
- Consensus was defined as ≥75% of experts scoring ≥7 on a 9-point Likert scale.
Main Results:
- 35 out of 53 (66%) experts participated, representing diverse specialties.
- Consensus was achieved in the third round for all proposed definitions.
- Highest consensus (96%) was observed for definitions of arm heaviness, fatigue, and pain.
Conclusions:
- Optimal definitions for 5 symptoms and 2 clinical signs of the UE-PTS score were established through expert consensus.
- The UE-PTS score requires further validation in a patient cohort before clinical and research implementation.
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