title: Use of venous duplex scans to evaluate symptoms of deep vein thrombosis: an analysis of ultrasound usage by various medical specialties.
abstract: In today's environment of cost-containment and utilization management, duplex ultrasound is often overused to evaluate symptoms of deep venous thrombosis/thrombophlebitis (DVT), reflecting the low diagnostic yield of such studies. We investigated the use of venous duplex scans by various medical specialties to determine whether a tendency exists to overuse this diagnostic tool by one specialty compared with others and to assess the cost-effectiveness of ordering this test for acute venous disease changes. We retrospectively reviewed the results of venous duplex ultrasound studies for 330 consecutive patients with suspected DVT for a 1-year period. Our analysis showed that 51 of 330 (16%) of all duplex scans ordered in our institution were positive for DVT. Internists, as a group, ordered 185 studies of which 26 were positive (14%). The surgeons' requests for duplex studies resulted in 23 of 137 (17%) confirmed positive studies. The overall positive examination rate was 16 per cent, which is not only suboptimal as a diagnostic tool, but also cumbersome with regard to health care cost-containment.
authors.affiliation: National Naval Medical Center, Bethesda, Maryland, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: McCoy
authors.forename: V
authors.initials: V
authors.lastname: Gahtan
authors.forename: M D
authors.initials: MD
authors.lastname: Kerstein
mesh_terms: D003362:Cost-Benefit Analysis; D003937:Diagnosis, Differential; D006801:Humans; D008396:Maryland; D008511:Medicine; D010414:Pennsylvania; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013038:Specialization; D014463:Ultrasonography / Q000191:economics / Q000706:statistics & numerical data; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000191:economics*