Simpler Test May Be Best for Diagnosing Blood Cl... (r initial assessment. Those in the 2-po...)

Simpler Test May Be Best for Diagnosing Blood Clots in Leg

Date:10/7/2008

r initial assessment. Those in the 2-point group with abnormal findings had a blood test called D-dimer that further assessed the risk of a blood clot, and were reassessed by 2-point ultrasound again in a week. If the findings were normal on the repeat test, they were not treated with blood-thinning medications. Abnormal findings on the repeat 2-point test warranted treatment, as did initial abnormal findings on the whole-leg test. Study volunteers from both groups were revaluated at three months.

During the three-month follow-up, blood clots were found in 0.9 percent of the 2-point group and in 1.2 percent of the whole-leg ultrasound group, according to the study.

"This study is an example of where the test with more bells and whistles doesn't have any advantage. One of the challenges of modern medicine is that as things get more complex, we have to make sure they're compared to what's tried and true. Here, they've identified that the simpler strategy works every bit as well," said Landefeld, who's a professor of medicine and chief of the division of geriatrics at the University of California, San Francisco.

Dr. Mark Adelman is chief of the division of vascular and endovascular surgery at New York University Langone Medical Center in New York City. He said that, while the study's findings were somewhat unexpected, he was pleased to see that the 2-point ultrasound along with the D-dimer test appeared to be just as effective in diagnosing most DVTs.

"In most hospitals, it's very difficult to do the total leg ultrasound. It requires skilled personnel, and it's very time-consuming," he said.

Adelman cautioned that anyone who has calf pain, swelling, redness or warmth that only occurs in one leg should be evaluated for DVT.

A good way to prevent DVT when flying, he said, is to make sure you stay hydrated with water -- coffee or alcohol can dehydrate you further. He also recommended getting up to walk at
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