title: [Validation of a clinical prediction rule for the diagnosis of deep vein thrombosis of the lower limbs in primary care].
abstract: OBJECTIVE
  Patients with suspected deep vein thrombosis (DVT) are often managed on an outpatient basis. The aim of the study was to validate a clinical prediction rule specifically for use in primary care to help physicians in their decision to start anticoagulant therapy while awaiting ultrasound examination.
  
  
  METHODS
  Between September 2007 and October 2008, 194 general practitioners prospectively included patients with clinically suspected DVT without clinically suspected pulmonary embolism. All patients underwent a standardized clinical assessment in order to collect items included in the clinical prediction rule (personal history of venous thromboembolism +1, immobilization in previous month+1, estrogen contraceptive+2, active malignancy+3, swelling of the calf+1, the presence of an alternative diagnosis more likely than that of DVT-3. DVT unlikely if score<2, likely if score≥2).
  
  
  RESULTS
  Among the 164 included patients, 56 (34%) had DVT of them 28 (17%) had a proximal DVT. Proportions of confirmed DVT were 29% in the unlikely group and 43% in the likely group against 26% and 63% respectively in the derivation study.
  
  
  CONCLUSIONS
  This clinical prediction rule might not fulfill the required conditions to be considered as a usable help in the ambulatory management of DVT. Variations of the cut-off value could enhance its performance.
authors.affiliation: Université européenne de Bretagne, 29200 Brest, France; EA3878, IFR 148, département de médecine interne et pneumologie, université de Brest, CHU de la Cavale-Blanche, Brest, France.
authors.forename: A
authors.initials: A
authors.lastname: Delluc
authors.forename: F
authors.initials: F
authors.lastname: Le Pape
authors.forename: A
authors.initials: A
authors.lastname: Le Bras
authors.forename: P
authors.initials: P
authors.lastname: Gagne
authors.forename: G
authors.initials: G
authors.lastname: Taton
authors.forename: M
authors.initials: M
authors.lastname: Jaffrelot
authors.forename: N
authors.initials: N
authors.lastname: Le Duff
authors.forename: L
authors.initials: L
authors.lastname: Bressollette
authors.forename: G
authors.initials: G
authors.lastname: Le Gal
mesh_terms: D000368:Aged; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D011320:Primary Health Care; D011446:Prospective Studies; D020246:Venous Thrombosis / Q000175:diagnosis*