Sensitivity and specificity of three-point compression ultrasonography test performed by emergency physicians for diagnosis of lower limbs deep venous thrombosis

Abstract

ABSTRACTBackground Ultrasonography is the first diagnostic tool used to diagnose lower extremities deep venous thrombosis, which represents a significant healthcare burden worldwide. In this study, we assess the sensitivity and specificity of the three-point compression ultrasonography performed by emergency physicians for diagnosis of deep vein thrombosis (DVT) were assessed.Methods One hundred patients were enrolled in a prospective cross-sectional study that was performed at the emergency department (ED) at Alexandria Main University Hospital after application of predefined criteria of Wells score. Every patient was examined twice, first by the emergency resident, and the second by radiology resident. Time to scan and duration of scan were calculated for both scans.Results There was a statistically significant relation between the duration to emergency department ultrasound and formal radiology Doppler (p = 0.001). Also, there was no statistically significant difference between the positivity of ED ultrasound and the results of formal Doppler with p = 0.453. In the analysis of the receiver operating characteristics (ROC) area under the ROC curve of 0.933* (95% CI: 0.874–0.992, p < 0.001) (sensitivity was 94.12%, specificity was 92.42%, and accuracy was 93.0%).Conclusion The ED Doppler ultrasound is a highly sensitive, highly specific, and accurate diagnostic tool, which can be conducted after shorter duration of admission to the ED. It can be used for faster clinical decision-making to decrease overcrowding at both the emergency and radiology departments to save time and allow early diagnosis and management.

Keywords

• Deep venous thrombosis (DVT)
• Emergency department ultrasound (EDUS)
• Doppler