Bruce L. Davidson, MD; C. Gregory Elliott, MD; Anthonie W. A. Lensing, MD
Davidson BL, Elliott CG, Lensing AWA. Color Doppler Ultrasound and Deep Venous Thrombosis. Ann Intern Med. 1993;118:906-907. doi: 10.7326/0003-4819-118-11-199306010-00020
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Published: Ann Intern Med. 1993;118(11):906-907.
Neither Dr. Merrell and colleagues nor Dr. White challenges our conclusion that color Doppler ultrasound examinations are insensitive to proximal deep venous thrombosis in asymptomatic high-risk patients after hip or knee arthroplasty .
Dr. Merrell and colleagues question our selection of only seven sites from the larger RD Heparin Arthroplasty Group trial that met the prospective entry criteria. The LDS Hospital peripheral vascular laboratory used gray-scale imaging and compression (not color Doppler); therefore, data from their center and other centers not using color Doppler ultrasound were excluded. Results from duplex scans at their center are the subject of another article , which notes that the 100% sensitivity of duplex scanning for detection of four proximal clots has a 95% CI that includes a sensitivity as low as 40%. The centers included did use comparable (although not identical) equipment in a consistent fashion. Finally, Merrell and colleagues misstate our conclusion as applying to duplex scanning, when in fact we discussed color Doppler ultrasound instead.
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