Use of venous duplex scans to evaluate symptoms of deep vein thrombosis: an analysis of ultrasound usage by various medical specialties
McCoy, K.L.; Gahtan, V.; Kerstein, M.D.
American Surgeon 65(5): 417-420
1999
ISSN/ISBN: 0003-1348 PMID: 10231207 Document Number: 502645
In today's environment of cost-containment and utilization management, duplex ultrasound is often overused to evaluate symptoms of deep venous thrombosis/thrombophlebitis (DVT), reflecting the low diagnostic yield of such studies. We investigated the use of venous duplex scans by various medical specialties to determine whether a tendency exists to overuse this diagnostic tool by one specialty compared with others and to assess the cost-effectiveness of ordering this test for acute venous disease changes. We retrospectively reviewed the results of venous duplex ultrasound studies for 330 consecutive patients with suspected DVT for a 1-year period. Our analysis showed that 51 of 330 (16%) of all duplex scans ordered in our institution were positive for DVT. Internists, as a group, ordered 185 studies of which 26 were positive (14%). The surgeons' requests for duplex studies resulted in 23 of 137 (17%) confirmed positive studies. The overall positive examination rate was 16 per cent, which is not only suboptimal as a diagnostic tool, but also cumbersome with regard to health care cost-containment.