PREDICTIVE POWER OF CLINICAL SYMPTOMS IN PATIENTS WITH PRESUMPTIVE DEEP VENOUS THROMBOSIS

The predictive power of clinical symptoms in the diagnosis of deep ven ous thrombosis (DVT) was assessed using a retrospective design. The sa mple consisted of 61 rehabilitation patients who were referred for Dop pler ultrasonography. Patients had a mean age of 60.6 (standard deviat ion, 18.4) years. Clinical measures documenting presence of swelling, warmth, fever, and lower limb asymmetry (>2.5 cm) were correlated with the outcome of venous duplex Doppler examinations. Clinical symptoms had low sensitivity (0.07-0.33) but generally higher specificity (0.76 -0.85) for DVT. Positive predictive power was lowest for fever (0.08) and highest for swelling (0.66). Prevalence rates for DVT were greates t (0.41) in patients presenting with multiple symptoms. Results sugges t clinical predictors of DVT remain elusive. A high rate of false-posi tives based on clinical findings from examination is acceptable given the low risk associated with ultrasonography and the clear benefit of early diagnosis of DVT.