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Importance of Pretest Probability Score and D-Dimer Assay Before Sonography for Lower Limb Deep Venous Thrombosis

Rathan M. Subramaniam1,2,3, Tina Chou1, Rebekah Heath1 and Robin Allen4

1 Academic and Research Division, Department of Radiology, Waikato Hospital, Hamilton, New Zealand.
2 Department of Radiology, Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
3 Present address: Department of Medical Imaging, The Canberra Hospital and the Australian National University, Canberra, Australia.
4 Department of Haematology, Waikato Hospital, Hamilton, New Zealand.



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Fig. 1 Flow chart shows study outcome of validation phase. Of 103 patients with unlikely pretest probability by Hamilton score and negative Simplify (Agen Biochemical) D-dimer assay, one patient had isolated calf deep venous thrombosis (DVT). Numbers refer to numbers of patients.

 


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Fig. 2 Flow chart shows diagnostic strategy for suspected lower limb deep venous thrombosis (DVT). Clinically excluding DVT by combining unlikely probability and negative D-dimer result can lead to a potential saving in health expenditures and allows timely discharge of patients.

 

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