Use of a Clinical Prediction Score in Patients with Suspected Deep Venous Thrombosis: Two Steps Forward, One Step Back?
Authors: James D. Douketis
Journal: Annals of Internal Medicine (2005)

Editorials19 July 2005Use of a Clinical Prediction Score in Patients with Suspected Deep Venous Thrombosis: Two Steps Forward, One Step Back?James D. Douketis, MDJames D. Douketis, MDFrom St. Joseph's Healthcare and McMaster University, Hamilton, Ontario, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-2-200507190-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Since antiquity, a measure of a physician's skill and experience has been the ability to predict at the bedside whether a disease is present or absent. In the current era, standardized clinical prediction scores (also known as clinical decision rules) can level the playing field so that physicians, irrespective of experience, can obtain an estimate of disease likelihood (1, 2). Clinical prediction scores can guide clinical management (for example, Ottawa ankle/knee rules), estimate adverse outcome risk (for example, Detsky score), and determine prognosis (for example, Acute Physiology and Chronic Health Evaluation [APACHE] score). The increasing availability of electronic medical records ...References1. McGinn TG, Guyatt GH, Wyer PC, Naylor CD, Stiell IG, Richardson WS. Users' guides to the medical literature: XXII: how to use articles about clinical decision rules. Evidence-Based Medicine Working Group. JAMA. 2000;284:79-84. [PMID: 10872017] CrossrefMedlineGoogle Scholar2. Laupacis A, Sekar N, Stiell IG. Clinical prediction rules. A review and suggested modifications of methodological standards. JAMA. 1997;277:488-94. [PMID: 9020274] CrossrefMedlineGoogle Scholar3. Shiffman RN, Michel G, Essaihi A, Thornquist E. Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation. 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[PMID: 12755550] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From St. Joseph's Healthcare and McMaster University, Hamilton, Ontario, Canada.Disclosures: None disclosed.Corresponding Author: James D. Douketis, MD, St. Joseph's Healthcare, Room F-541, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada; e-mail, [email protected]ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Wells Rule Does Not Adequately Rule Out Deep Venous Thrombosis in Primary Care Patients Ruud Oudega , Arno W. Hoes , and Karel G.M. Moons Meta-Analysis: The Value of Clinical Assessment in the Diagnosis of Deep Venous Thrombosis Steve Goodacre , Alex J. Sutton , and Fiona C. Sampson Metrics Cited ByAvoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates'Clinical scoring system for assessment of deep venous thrombosisFormative assessment and design of a complex clinical decision support tool for pulmonary embolismUsability Testing of a Complex Clinical Decision Support Tool in the Emergency Department: Lessons LearnedClinical probability assessment and D-dimer determination in patients with suspected deep vein thrombosis, a prospective multicenter management studyVena cava inferior thrombosis detected by venous hum: a case reportUpdate in the diagnosis of deep-vein thrombosis and pulmonary embolism 19 July 2005Volume 143, Issue 2Page: 140-142KeywordsConfidence intervalsDeep vein thrombosisElectronic medical recordsPopulation statisticsSigns and symptomsThrombosisUltrasound imagingVeins ePublished: 19 July 2005 Issue Published: 19 July 2005 CopyrightCopyright © 2005 by American College of Physicians. 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