title: Repeat duplex ultrasound scanning in suspected Deep Vein Thrombosis (DVT): putting the onus back on the referring clinician.
abstract: Duplex scanning is utilised by many departments in the investigation of suspected DVT. NICE Guideline CG144 recommended repeat scanning for patients in whom the initial Wells score was 'likely' in the presence of a raised D-Dimer, following a normal first scan. Following implementation of this recommendation in our department there was a dramatic rise in the number of repeat scans being undertaken, all of which were negative for DVT. Introduction of an electronic message to the report, placing the onus back on the referring clinician to arrange repeat scan if deemed appropriate resulted in a fall in the number of scans being undertaken without impacting on patient outcome.
authors.affiliation: Consultant Physician in Acute Medicine, Royal Liverpool University Hospital, Acute Medical Unit, Prescot Street, Liverpool, L7 8XP.
authors.forename: Bryan
authors.initials: B
authors.lastname: Renton
authors.forename: S
authors.initials: S
authors.lastname: Thiru
authors.forename: C P
authors.initials: CP
authors.lastname: Griffin
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods; D019468:Disease Management; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D000069342:Medical Overuse / Q000517:prevention & control*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods / Q000706:statistics & numerical data; D006113:United Kingdom; D020246:Venous Thrombosis / Q000175:diagnosis / Q000628:therapy
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D