Document Detail


Contrast venography, the gold standard for the diagnosis of deep-vein thrombosis: improvement in observer agreement.
MedLine Citation:
PMID:  1615489     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine whether the Rabinov-Paulin or the long-leg venography technique should be preferred in the diagnostic management of patients with clinically suspected deep-vein thrombosis, two independent experienced radiologists blindly assessed two different series of venograms of consecutive outpatients with clinically suspected deep-vein thrombosis. Venograms were obtained from two outpatient clinics of primary referral centres. In one centre the venograms were performed according to the technique of Rabinov and Paulin with the use of 100 ml of radiographic material and spot films of the calf, popliteal and more proximal veins. In the other centre, long-leg films were obtained after the administration of 150 ml of contrast material. The percentage venograms adjudicated as inadequate by at least one radiologist and inter-observer disagreement for both series were used as the main study outcome measures. Prior to the study, both radiologists agreed on the standardized criteria for a normal, abnormal and inadequate test result using a separate set of films. An inadequacy rate of 20% was found for the Rabinov-Paulin venography series (n = 123), whereas only 2% of the 126 long-leg films were inadequate for interpretation (p less than 0.001). The inter-observer diagreement for inadequacy, presence or absence of deep-vein thrombosis was 21% for the Rabinov and Paulin venograms and 4% for the long-leg films (kappa, 0.65 and 0.92; 95% confidence intervals: 0.53 to 0.77 and 0.84 to 0.99, respectively; p less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
A W Lensing; H R Büller; P Prandoni; D Batchelor; A H Molenaar; A Cogo; M Vigo; P M Huisman; J W ten Cate
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  67     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-07-24     Completed Date:  1992-07-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  8-12     Citation Subset:  IM    
Affiliation:
Centre for Thrombosis, Haemostasis and Atherosclerosis Research, Academic Medical Centre, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Evaluation Studies as Topic
Female
Humans
Male
Middle Aged
Observer Variation
Phlebography / methods,  statistics & numerical data*
Thrombophlebitis / diagnosis,  radiography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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