Deep Venous Thrombosis Clinical Trial
Official title:
Prospective Observational Trial of Point-of-Care, Limited Ultrasonography (PLUS) for Lower Extremity Deep Venous Thrombosis in the Emergency Department: The Sonography Outcomes Assessment Program (SOAP-4 Trial)
Currently, most emergency physicians have limited access to obtaining formal radiology
ultrasound studies, particularly overnight. Many are forced to adopt risky and expensive
strategies in managing their patients with suspected deep venous thrombosis (DVT) who
present during off-hours: for low risk patients, discharging without anticoagulation and
arranging for outpatient studies; for moderate to high risk patients, empirically
anticoagulating and admitting to the hospital to await definitive testing. If emergency
physicians could reliably perform an accurate ultrasound exam for DVT, such risks could be
obviated.
This is a prospective, observational cohort study assessing the accuracy of emergency
physician diagnosis of proximal DVT using compact ultrasound equipment and a simplified
compression technique. The value of color flow doppler and augmentation will also be
assessed. Outcomes (sensitivity, specificity, positive likelihood ratio and negative
likelihood ratio) will be assessed at 30 days.
Prior to enrolling patients in the study, emergency physicians will undertake a 2 hour
training course on the performance of the simplified compression technique for the diagnosis
of lower extremity DVT. Emergency physicians will perform the DVT ultrasound exam on study
subjects with suspected DVT. Clinical management of the study subjects will not be altered;
all subjects will proceed to receive a formal DVT ultrasound study by the radiology
department which will serve as the criterion reference for the study.
n/a
Allocation: Random Sample, Primary Purpose: Screening, Time Perspective: Cross-Sectional
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