title: The Saudi clinical practice guideline for the diagnosis of the first deep venous thrombosis of the lower extremity.
abstract: The diagnosis of deep venous thrombosis (DVT) may be challenging due to the inaccuracy of clinical assessment and diversity of diagnostic tests. On one hand, missed diagnosis may result in life-threatening conditions. On the other hand, unnecessary treatment may lead to serious complications. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia (KSA), an expert panel led by the Saudi Association for Venous Thrombo-Embolism (SAVTE; a subsidiary of the Saudi Thoracic Society) with the methodological support of the McMaster University Working Group, produced this clinical practice guideline to assist healthcare providers in evidence-based clinical decision-making for the diagnosis of a suspected first DVT of the lower extremity. Twenty-four questions were identified and corresponding recommendations were made following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. These recommendations included assessing the clinical probability of DVT using Wells criteria before requesting any test and undergoing a sequential diagnostic evaluation, mainly using highly sensitive D-dimer by enzyme-linked immunosorbent assay (ELISA) and compression ultrasound. Although venography is the reference standard test for the diagnosis of DVT, its use was not recommended.
authors.affiliation: Department of Intensive Care, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs Jeddah, Saudi Arabia.
authors.forename: Fahad
authors.initials: F
authors.lastname: Al-Hameed
authors.affiliation: Department of Intensive Care, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs Jeddah, Saudi Arabia.
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Al-Dorzi
authors.affiliation: Department of Radiology, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Shamy
authors.affiliation: Department of Medicine, King Fahad General Hospital, Jeddah, Saudi Arabia.
authors.forename: Abdulelah
authors.initials: A
authors.lastname: Qadi
authors.affiliation: Department of Medicine, King Fahad Medical City, Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Ebtisam
authors.initials: E
authors.lastname: Bakhsh
authors.affiliation: Department of Surgery, Um Al Qura University, Makkah, Saudi Arabia.
authors.forename: Essam
authors.initials: E
authors.lastname: Aboelnazar
authors.affiliation: Department of Pathology, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Abdelaal
authors.affiliation: Department of Medicine, King Fahad General Hospital, Jeddah, Saudi Arabia.
authors.forename: Tarig
authors.initials: T
authors.lastname: Al Khuwaitir
authors.affiliation: Department of Medicine, King Abdulaziz Medical City, Riyadh, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Al-Moamary
authors.affiliation: King Saud University, Saudi Arabia.
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Al-Hajjaj
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada ; Department of Medicine, McMaster University, Hamilton, Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Brozek
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada ; Department of Medicine, McMaster University, Hamilton, Canada.
authors.forename: Holger
authors.initials: H
authors.lastname: Schünemann
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada ; Department of Internal Medicine and Nephrology, University of Missouri-Kansas City, Kansas City, Missouri, United States.
authors.forename: Reem
authors.initials: R
authors.lastname: Mustafa
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada ; Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil.
authors.forename: Maicon
authors.initials: M
authors.lastname: Falavigna
keywords: Clinical practice guideline; Saudi Arabia; deep venous thrombosis; diagnosis; venous thromboembolism