Use of venous duplex scans to evaluate symptoms of deep vein thrombosis: An analysis of ultrasound usage by various medical specialties

In today's environment of cost-containment and utilization management, dupl ex ultrasound is often overused to evaluate symptoms of deep venous thrombo sis/thrombophlebitis (DVT), reflecting the low diagnostic yield of such stu dies. We investigated the use of venous duplex scans by various medical spe cialties to determine whether a tendency exists to overuse this diagnostic tool by one specialty compared with others and to assess the cost-effective ness of ordering this test for acute venous disease changes. We retrospecti vely reviewed the results of venous duplex ultrasound studies for 330 conse cutive patients with suspected DVT for a 1-year period. Our analysis showed that 51 of 330 (16%) of all duplex scans ordered in our institution were p ositive for DVT. Internists, as a group, ordered 185 studies of which 26 we re positive (14%). The surgeons' requests for duplex studies resulted in 23 of 137 (17%) confirmed positive studies. The overall positive examination rate was 16 per cent, which is not only suboptimal as a diagnostic tool, bu t also cumbersome with regard to health care cost-containment.