ArticleAnnals of family medicine2017
General Practitioner-Performed Compression Ultrasonography for Diagnosis of Deep Vein Thrombosis of the Leg: A Multicenter, Prospective Cohort Study.
Registry-linked trialOpen access · diamondAbstract readMulticenter Study
In one paragraph
Article in Annals of family medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05550038 (Diagnostic Performance of General Practitioners in Compression Ultrasound for the Diagnosis of Proximal Deep Vein Thrombosis of the Lower Limbs), which is not on this map. Cited by 17 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
3.9field-weighted citation impact, top 6% of its field
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diagnostic Performance of General Practitioners in Compression Ultrasound for the Diagnosis of Proximal Deep Vein Thrombosis of the Lower Limbs
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Point-of-Care Ultrasound in General Practice: A Systematic Review.Annals of family medicine · 2019Pooled it
- Point-of-care ultrasound in prehospital emergency care: attitudes, facilitators and barriers.BMC medical education · 2026Article
- Lowering DVT-Related ED Visits via a Primary Care POCUS Pathway.POCUS journal · 2026Article
- The utility of point of care ultrasonography (POCUS).Annals of medicine and surgery (2012) · 2021Article
- Non-invasive diagnosis of deep vein thrombosis from ultrasound imaging with machine learning.NPJ digital medicine · 2021Article
- The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis.Journal of clinical medicine · 2021Review
- Teaching limited compression ultrasound to general practitioners reduces referrals of suspected DVT to a hospital: a retrospective cross-sectional study.The ultrasound journal · 2021Article
- Time-efficient and contrast-free magnetic resonance imaging approach to the diagnosis of deep vein thrombosis on black-blood gradient-echo sequence: a pilot study.Quantitative imaging in medicine and surgery · 2021Article
- Direct-access to sonographic diagnosis of deep vein thrombosis in general practice: a descriptive cohort study.BMC family practice · 2020Article
- Use and impact of point-of-care ultrasonography in general practice: a prospective observational study.BMJ open · 2020Observational
- Is there a place for point-of-care ultrasound in UK primary care?The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Point-of-care ultrasound for general practitioners: a systematic needs assessment.Scandinavian journal of primary health care · 2020Article
- Point-of-care ultrasound in primary care: a systematic review of generalist performed point-of-care ultrasound in unselected populations.The ultrasound journal · 2019Review
- Hospitalist-Operated Compression Ultrasonography: a Point-of-Care Ultrasound Study (HOCUS-POCUS).Journal of general internal medicine · 2019Article
- Vascular Ultrasound Statement from the Department of Cardiovascular Imaging of the Brazilian Society of Cardiology - 2019.Arquivos brasileiros de cardiologia · 2019Article
- Comparison Between the Diagnostic Performance of 1.5 T and 3.0 T field Strengths for Detecting Deep Vein Thrombosis Using Magnetic Resonance Black-Blood Thrombus Imaging.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
- Beyond the Stethoscope: Point-of-Care Ultrasound (POCUS) as the New Norm in Family Medicine.Journal of the American Board of Family Medicine : JABFMArticle
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 2 countries.
Nicola MumoliDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali). nimumoli@tiscali.it.
Josè VitaleDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Matteo Giorgi-PierfranceschiDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Silvia SabatiniDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Renato TulinoDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Marco CeiDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Eugenio BucheriniDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Carlo BovaDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Daniela MastroiacovoDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Alberto CamaitiDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Gerardo PalmieroDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Luca PuccettiDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
Francesco DentaliDepartment of Internal Medicine, Ospedale Civile di Livorno, Livorno, Italy (Mumoli, Cei, Camaiti, Palmiero); Department of Internal Medicine, Ospedale Beata Vergine di Mendrisio, Ticino, Switzerland (Vitale); Emergency Department, Ospedale della Val d'Arda, Piacenza, Italy (Giorgi-Pierfranceschi); Primary Ambulatory Care, Livorno, Italy (Sabatini); Primary Care, Porto Santo Stefano, Grosseto, Italy (Tulino); Department of Vascular Medicine, ASL Di Romagna, Ravenna, Italy (Bucherini); Department of Internal Medicine, Azienda Ospedaliera, Cosenza, Italy (Bova); Angiology Unit, ASL 1 Avezzano Sulmona L'Aquila, Avezzano (AQ), Italy (Mastroiacovo); Primary Ambulatory Care, Pisa, Italy (Puccetti); Department of Internal Medicine, Ospedale di Circolo, Varese, Varese, Italy (Dentali).
PRACTICUS Study Investigators
Ospedale di Livorno · ITOspedale Regionale di Mendrisio · CHAzienda Ospedaliera di Cosenza · ITAzienda Unità Sanitaria Locale Della Romagna · IT
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with suspected deep vein thrombosis (DVT) of the lower limb represent a diagnostic dilemma for general practitioners. Compression ultrasonography (US) is universally recognized as the best test of choice. We assessed the diagnostic accuracy of compression US performed by general practitioners given short training in the management of symptomatic proximal DVT.
methodsFrom May 2014 to May 2016, we evaluated in a multicenter, prospective cohort study all consecutive outpatients with suspected DVT; bilateral proximal lower limb compression US was performed by general practitioners and by physicians expert in vascular US, each group blinded to the other's findings. In all examinations with a negative or nondiagnostic result, compression US was repeated by the same operator after 5 to 7 days. Inter-observer agreement and accuracy were calculated.
resultsWe enrolled a total of 1,107 patients. The expert physicians diagnosed DVT in 200 patients, corresponding to an overall prevalence of 18.1% (95% CI, 15.8%-20.3%). The agreement between the trained general practitioners and the experts was excellent (Cohen κ = 0.86; 95% CI, 0.84-0.88). Compression US performed by general practitioners had a sensitivity of 90.0% (95% CI, 88.2%-91.8%) and a specificity of 97.1% (95% CI, 96.2%-98.1%) with a diagnostic accuracy for DVT of 95.8% (95% CI, 94.7%-97.0%).
conclusionsOur results suggest that, even in hands of physicians not expert in vascular US, compression US can be a reliable tool in the diagnosis of DVT. We found that the sensitivity achieved by general practitioners appeared suboptimal, however, so future studies should evaluate the implementation of proper training strategies to maximize skill.
Indexed as
General PractitionersAdultAgedAged, 80 and overFemaleHumansItalyLegMaleMiddle AgedProspective StudiesSensitivity and SpecificityUltrasonographyVenous ThrombosisYoung Adultaccuracycompression ultrasounddeep vein thrombosisdiagnosisgeneral practitionerpractice-based researchprimary care
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Registered trials
NCT05550038ClinicalTrials.gov
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