深静脉血栓症的临床评估的准确性
P S Wells1, J Hirsh, D R Anderson
1Ottawa Civic Hospital, Ontario, Canada.
Lancet (London, England)
|May 27, 1995
概括
一个新的临床模型准确地预测了门诊患者的深静脉血栓形成 (DVT) 概率. 将这种模型与静脉超声波相结合,简化了诊断,并减少了疑似深静脉血栓的不必要测试.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 心血管医学 心血管医学
- 临床流行病学临床流行病学
背景情况:
- 深静脉血栓症 (DVT) 的临床诊断通常被认为是不可靠的.
- 有必要改善疑似DVT的诊断策略.
研究的目的:
- 开发和前性测试一种临床模型,用于对疑似DVT的患者进行分层.
- 评估这种模型与静脉超声波的组合,以简化诊断方法.
主要方法:
- 一个临床模型被开发和测试在3个三级护理中心.
- 评估了529名患有疑似DVT的有症状的门诊患者.
- 患者接受了临床评估,静脉超声波和静脉扫描.
主要成果:
- 临床模型预测DVT患病率为85% (高),33% (中等) 和5% (低) 的预测概率.
- 该模型显示了卓越的观察者间可靠性 (Kappa = 0.85).
- 将模型与超声波相结合,提高了诊断准确度,特别是当结果不一致时.
结论:
- 开发的临床模型有效地对疑似DVT的患者进行了分层.
- 将临床模型与静脉超声波相结合,提供了简化和更准确的诊断途径.
- 排除具有正常超声波结果的低概率患者可以减少进一步测试的需要.
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