Table 1.
Summary of included studies for first-episode and recurrent DVT of the lower extremity
| Study, author (year) | Population | Clinical setting | Index test | Reference standard |
|---|---|---|---|---|
| Aguilar and del Villar (2007)56 | Recurrent DVT | Outpatient, emergency department | “DVT unlikely” patients: D-dimer | If D-dimer positive → proximal compression US |
| If D-dimer negative → 3-mo follow-up | ||||
| “DVT likely” patients: proximal compression US | If US positive → serial US (repeat proximal compression US at 1 wk) | |||
| If US negative → DVT ruled out | ||||
| Anderson et al (1999)14 | First episode suspected DVT | Outpatient, emergency department | Proximal compression US, serial US* | Venography or serial US, 3-mo follow-up |
| Serial US strategy was compression US for moderate PTP patients, if normal then repeat compression US at 1 wk, if normal then 3-mo follow-up. | ||||
| Aronen et al (1994)15 | Suspected DVT, unspecified if first episode or recurrent | Inpatient | Proximal compression US | Venography |
| Bendayan and Boccalon (1991)51 | Suspected DVT, unspecified if first episode or recurrent | Outpatient | Whole-leg US | Venography |
| Bernardi et al (1998)34 | Suspected DVT, unspecified if first episode or recurrent | Outpatient | Serial US* | 3-mo follow-up |
| Serial US strategy was compression US for all patients, if normal then D-dimer test, if abnormal then repeat compression US at 1 wk, if normal then 3-mo follow-up | ||||
| Birdwell et al (1998)35 | First-episode suspected DVT | Outpatient | Serial US* | 3-mo follow-up |
| Serial US strategy was compression US for all patients, if normal then repeat compression US at 5-7 d, if normal then 3-mo follow-up | ||||
| Birdwell et al (2000)16 | First episode suspected DVT | Outpatient | Proximal compression US | Serial US after normal proximal compression US, venography after abnormal US, 3-mo follow-up |
| Bradley et al (1993)27 | Suspected DVT, unspecified if first episode or recurrent | NR | Whole leg US | Venography |
| Canan et al (2012)38 | First episode suspected DVT | Inpatient, admitted to emergency or cardiovascular surgery department | D-dimer (STA Liatest, 0.5 ug/mL) | Proximal compression US |
| Cornuz et al (2002)39 | Suspected DVT, unspecified if first episode or recurrent | Outpatient, vascular laboratory | D-dimer (ELISA, 500 μg/mL) with Wells score | Whole-leg US |
| Cogo et al (1993)17 | Suspected DVT, unspecified if first episode or recurrent | Outpatient - thrombosis unit | Proximal compression US | Venography |
| D’Angelo et al (1996)40 | First episode or recurrent suspected DVT | NR, coagulation service | D-dimer (0.50 μg/mL) | Proximal compression US/serial US |
| de Valois et al (1990)28 | Suspected DVT, unspecified if first episode or recurrent | NR | Whole-leg US | Contrast venography |
| Diamond et al (2005)41 | Suspected DVT, unspecified if first episode or recurrent | Outpatient, emergency department | D-dimer (Tinaquant, 0.5 μg/mL) | Whole leg US |
| Friera et al (2002)18 | Suspected DVT, unspecified if first episode or recurrent | Emergency department, inpatient, and outpatient | Proximal compression US, serial US* | Serial US (repeat proximal compression US) or 3-mo follow-up |
| Serial US strategy was compression US for all patients, if normal then assessment of clinical probability, if intermediate or high then repeat compression US at 7 d, if normal then rule out DVT. Three-month follow-up was only for patients who refused repeat US | ||||
| Grosser et al (1990)52 | Suspected DVT, unspecified if first episode or recurrent | Inpatient | Whole-leg US | Venography |
| Grosser et al (1991)53 | Suspected DVT, unspecified if first episode or recurrent | NR | Whole-leg US | Venography |
| Gudmundsen et al (1990)19 | Suspected DVT, unspecified if first episode or recurrent | NR | Proximal compression US | Venography |
| Habscheid et al (1990)29 | Suspected DVT, unspecified if first episode or recurrent | NR | Whole leg US | Venography |
| Haenssle et al (2013)42 | Suspected DVT, unspecified if first episode or recurrent | Inpatient | D-dimer (Tinaquant) | Whole leg US or phlebography |
| Hansson et al (1994)43 | Suspected DVT, unspecified if first episode or recurrent | Inpatient, admitted to emergency unit | D-dimer (ELISA) | Phlebography |
| Ilkhanipour et al (2004)54 | Suspected DVT, unspecified if first episode or recurrent | Outpatient, emergency department | D-dimer assay (ELISA bioMerieux ≥500 μg/L) | Proximal compression US (for low- and intermediate-PTP patients), serial US (for high-PTP patients) |
| Jennersjö et al (2005)44 | Suspected DVT, unspecified if first episode or recurrent | Outpatient, emergency department | D-dimer (Tinaquant, 0.5 mg/L FEU) | Whole-leg US |
| Kalodiki et al (1993)30 | Suspected DVT, unspecified if first episode or recurrent | NR | Whole-leg US | Venography |
| Knecht and Heinrich (1997)45 | Suspected DVT, unspecified if first episode or recurrent | NR | D-dimer (Tinaquant, 500 mg/L) | Duplex US, Ascending venography |
| Le Blanche et al (1999)46 | First episode suspected DVT | Inpatient | D-dimer (VIDAS, 500 ng/mL) | Proximal compression US |
| Lensing et al (1989)20 | Suspected DVT, unspecified if first episode or recurrent | Outpatient | Proximal compression US | Venography |
| Luxembourg et al (2012)47 | First episode or recurrent suspected DVT | NR | D-dimer (VIDAS, 500 ng/mL) | Whole-leg US, phlebography (if inadequate US), 3-mo follow-up if negative US of the symptomatic leg |
| Mantoni et al (2008)55 | First episode DVT | Outpatient, referred to the hospital | D-dimer (STA Liatest, ≥0.5 mg/L) | Whole-leg US (high PTP and positive D-dimer), 6-mo follow-up (low or moderate PTP and negative D-dimer) |
| Miller et al (1996)31 | Suspected DVT, unspecified if first episode or recurrent | NR | Whole-leg US | Venography |
| Montefusco-von Kleist et al (1993)32 | Suspected DVT, unspecified if first episode or recurrent | NR | Whole-leg US | Ascending contrast venography |
| Nata et al (2013)48 | First episode or recurrent suspected DVT | Inpatient and outpatient | D-dimer (rapid quantitative latex-based immunoagglutination assay, 0.5 μg/mL) | Proximal compression US and CT |
| Oudega et al (2005)49 | First episode or recurrent suspected DVT | Outpatient, primary care | D-dimer (VIDAS 500 ng/mL) | Serial US |
| Pedersen et al (1991)21 | Suspected DVT, unspecified if first episode or recurrent | Inpatient | Proximal compression US | Contrast venography |
| Quintavalla et al (1992)22 | Suspected DVT, unspecified if first episode or recurrent | NR | Proximal compression US | Ascending venography |
| Schutgens et al (2005)50 | Suspected DVT, unspecified if first episode or recurrent | Outpatient | Serial US*, D-dimer (Tinaquant, 0.5 mg/L) + pretest probability | Proximal US, 3-mo follow-up |
| Serial US strategy was D-dimer for all patients, if normal then single compression US and if abnormal then serial US as described in Birdwell et al, 1998. If normal US results, then 3-mo follow-up. | ||||
| Theodorou et al (2003)33 | First episode or recurrent suspected DVT | NR | Whole-leg US | Contrast-enhanced venography |
| van Ramshorst et al (1991)23 | First episode suspected DVT | NR | Proximal compression US | Venography |
| Wells et al (1995)25 | First episode suspected DVT | Outpatient | Proximal compression US | Venography, 6-mo follow-up (if negative results) |
| Wells et al (1995)26 | First episode suspected DVT | Outpatient | Proximal compression US | Venography, 3-mo follow-up |
| Wells et al (2003)24 | First episode or recurrent suspected DVT | Outpatient, thrombosis unit and emergency department | Proximal compression US | 3-mo follow-up |
| Williams et al (2005)36 | First episode suspected DVT | Outpatient | Serial US*, D-dimer | Proximal compression US or serial US, 6-wk follow-up (if negative tests) |
| Serial US strategy was compression US and D-dimer for moderate-/high-risk score patients, if normal US then repeat US at 1 wk for moderate- or high-risk patients who also have abnormal D-dimer and strain gauge plethysmography |
The following studies were translated from foreign languages: Bendayan and Boccalon (1991) (French), Grosser et al (1990) (German), Grosser et al (1991) (German), and Mantoni et al (2008) (Danish).
CT, computed tomography; ELISA, enzyme-linked immunosorbent assay; NR, not reported.
*
For all studies conducting serial US, the complete serial US strategy was considered an index test (rather than the single repeat US), and clinical follow-up alone was taken as the reference standard.