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Q In patients with suspected deep venous thrombosis (DVT) and negative results on proximal vein ultrasonography, how does a D-dimer–based management strategy that minimises additional assessments compare with routine repeated ultrasonography?
Clinical impact ratings IM/Ambulatory care ★★★★★★☆ Emergency medicine ★★★★★☆☆ Haematology ★★★★★★☆
METHODS
Design:
randomised controlled trial.
Allocation:
concealed.*
Blinding:
blinded (outcome assessors).*
Follow up period:
6 months.
Setting:
thrombosis services of 4 university hospitals in Hamilton, Ontario, Canada.
Patients:
810 patients (mean age 59.5 y, 62% women) with a suspected first episode of DVT and negative results on proximal vein ultrasonography who were referred by primary care and hospital-based physicians to a thrombosis outpatient service. Exclusion criteria included life expectancy <6 months, contraindication to venography, use of full dose heparin for >48 hours, use of long term warfarin therapy, symptoms of pulmonary embolism, and …