« Back
Appropriateness of Repeat US Doppler Requests for DVT
Poster Title: Appropriateness of Repeat US Doppler Requests for DVT
Submitted on 13 Sep 2018
Author(s): Dr Bahareh Gholipour, Dr Madiha Hussain, Adshara Vimalanathan
Affiliations: Radiology Department, Whittington Hospital, Whittington Health NHS Trust
This poster was presented at BIR 2018
Poster Views: 250
View poster »

Poster Information
Abstract: Title: Appropriateness of Repeat US Doppler Requests for DVT.

Background: NICE guidelines state that repeat DVT scans are only indicated in cases of high clinical suspicion (Wells score >1) with a normal initial scan and a subsequent raised D-dimer. In our department, a rising number of repeat Doppler scan requests were noted with a suspected low positive yield. An audit was therefore performed to determine whether the guidelines are being followed (i.e. appropriate requests) and to identify the positive detection rate in repeat scans.

Standards & Targets: RCR (1) and NICE guidelines (2) state that 100% of the requests should document the Wells score (+/-D-dimer) in appropriate referrals. Systematic review (3) on diagnostic yield of repeat scans suggest a positive detection rate of at least 15%.

Methodology: 50 patients who had a repeat US doppler were identified using PACS. The following data was collected: Appropriateness of requests - i.e. Inclusion of Wells Score (+/- D-dimer) on request forms and presence of DVT on repeat doppler reports.

Results: Overall only 11 requests (22%) documented the Wells score (only 8 of which had a score >1). Only 4 repeat scans (8%) were positive for DVT.

Conclusion: Standards are currently not being met - thought to be secondary to low awareness of guidelines, given the lack of suitable requests. We therefore plan to raise awareness through junior doctor teaching and by posting NICE algorithm posters in clinical environments and creating a mandatory section on DVT request forms (Wells score +/- D-dimer) with a re-audit in 6 months to assess impact of the changes made.
Summary: Appropriateness of repeat US doppler requests for the investigation of DVT and local positive detection rate.References: 1. RCR Guidelines:
2. NICE Guidelines: CG144 Venous thromboembolic diseases (2012 updated 2015)
3. Goodacre S, Sampson F, Thomas S, van Beek E, Sutton A. Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis. BMC medical imaging. 2005;5(1):6.
Report abuse »
Creative Commons

Related Posters

The Good, the Bad and the Ugly: Selective single cell isolation
Sandra Lubos1,2, Nils Körber1, Heide Marie Resch1, Iris Augustin2, Stefan Niehren1

Muito mais que um dedo vermelho - Um relato de caso de Trombocitose Essencial
Andrade Rosa, Inês; Cardoso Coelho, Cecília; Rocha, Luísa

Duração da antibioterapia em infeções bacterianas pediátricas - uma revisão
Andrade Rosa, Inês; Lima, Marina; Pacheco, Pedro

Osteolytic jaw lesions
Dr. Amal Hassan Zakarya, Sarah Ahmed Mohamed, Noura Mohamed Kamal, Heba Ahmed Saleh, Ali Abd Elwahed

Evaluation of the Orion Outlier Detection Algorithm for Data Streams
Nam Phung