ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2010
Diagnostic classification in patients with suspected deep venous thrombosis: physicians' judgement or a decision rule?
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of studies comparing diagnostic clinical prediction rules with clinical judgment.PloS one · 2015Pooled it
- Impact of a diagnostic strategy for appendicitis in children with acute abdominal pain in primary care: study protocol for a hybrid type 1 cluster randomised controlled trial.Diagnostic and prognostic research · 2026Review
- Risk stratification in pulmonary embolism: current evidence and future directions.The Journal of cardiovascular surgery · 2026Review
- Improving event prediction using general practitioner clinical judgement in a digital risk stratification model: a pilot study.BMC medical informatics and decision making · 2024Article
- Clinical decision rules in primary care: necessary investments for sustainable healthcare.Primary health care research & development · 2023Article
- Two point-of-care test-based approaches for the exclusion of deep vein thrombosis in general practice: a cost-effectiveness analysis.BMC primary care · 2023Article
- Identifying frailty in primary care: a qualitative description of family physicians' gestalt impressions of their older adult patients.BMC family practice · 2018Article
- Ruling Out Pulmonary Embolism in Primary Care: Comparison of the Diagnostic Performance of "Gestalt" and the Wells Rule.Annals of family medicine · 2016Article
- Accuracy in diagnosing deep and pelvic vein thrombosis in primary care: an analysis of 395 cases seen by 58 primary care physicians.Deutsches Arzteblatt international · 2012Article
- Self-monitoring of listening abilities in normal-hearing children, normal-hearing adults, and children with cochlear implants.Journal of the American Academy of Audiology · 2012Article
- Search filters for finding prognostic and diagnostic prediction studies in Medline to enhance systematic reviews.PloS one · 2012Article
- Deep venous thrombosis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Article
- Diagnostic classification in patients with deep venous thrombosis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Article
- A Machine Learning Approach to Predict Deep Venous Thrombosis Among Hospitalized Patients.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical decision rules can aid in referral decisions for ultrasonography in patients suspected of having deep venous thrombosis (DVT), but physicians are not always convinced of their usefulness and rely on their own judgement.
aimTo compare the performance of a clinical decision rule with the probability of DVT presence as estimated by GPs. DESIGN OF STUDY: Cross-sectional survey.
settingPrimary care practices in The Netherlands.
methodGPs (n = 300) estimated the probability of the presence of DVT (range 0-100%) and calculated the score for the clinical decision rule in 1028 consecutive patients with suspected DVT. The clinical decision rule uses a threshold of three points and so, for the GP estimates, thresholds were introduced at 10% and 20%. If scores were below these estimates, it was not considered necessary to refer patients for further examination. Differences between the clinical decision rule and the GP estimates were calculated; this is discrimination (c-statistic) and classification of patients.
resultsData of 1002 patients were eligible for analysis. DVT was observed in 136 (14%) patients. Both the clinical decision rule and GP estimates had good discriminative power (c-statistic of 0.80 and 0.82 respectively). Fewer patients were referred when using the clinical decision rule compared with a referral decision based on GP estimates: 51% versus 79% and 65% (thresholds at 10% and 20% respectively). Both strategies missed a similar and low proportion of patients who did have DVT (range 1.4-2.0%).
conclusionIn patients suspected of DVT both GP estimates and a clinical decision rule can safely discriminate in patients with and without DVT. However, fewer patients are referred for ultrasonography when GPs rely on a clinical decision rule to guide their decision making.
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