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Failure of computerized impedance plethysmography in the diagnostic management of patients with clinically suspected deep-vein thrombosis.
Thromb Haemost. 1991 Mar 04; 65(3):233-6.TH

Abstract

Before a new diagnostic modality can be introduced in clinical medicine, the validity of both a normal and abnormal test result have to be assessed prospectively in an appropriate patient group. We have evaluated the clinical validity of a new computerized impedance plethysmography (CIP) in the diagnostic management of 381 consecutive patients with clinically suspected venous thrombosis. In patients with serially normal CIP results, the diagnosis of venous thrombosis was refuted and, consequently, they were not treated with anticoagulant therapy and all were followed up for a period of 6 months to estimate the occurrence of symptomatic venous thromboembolism. The study was prematurely terminated by the safety monitoring committee because of an unacceptably high incidence of confirmed venous thromboembolism (10 patients, 3.2%; 95% confidence interval: 1.6% to 6%), including 4 episodes of fatal pulmonary embolism. In a subsequent explanatory study using ultrasonography in 29 other symptomatic patients who had at least 2 repeated normal CIP test results, the failure of CIP to detect proximal vein thrombosis was confirmed in 4 patients (14%). The reasons for this failure are probably related to the use of a modified device to measure impedance in the CIP apparatus, resulting in a lower ability to separate patients without venous thrombosis from those with the disease. We concluded that CIP is insensitive for the detection of proximal vein thrombosis and, therefore, not clinically useful in the diagnostic management of patients with suspected venous thrombosis.

Authors+Show Affiliations

Prandoni P
Second Institute of Internal Medicine, University Hospital of Padua, Italy.
Lensing AW
No affiliation info available
Büller HR
No affiliation info available
Carta M
No affiliation info available
Vigo M
No affiliation info available
Cogo A
No affiliation info available
Cuppini S
No affiliation info available
ten Cate JW
No affiliation info available

MeSH

AdolescentAdultAgedAged, 80 and overComputersFollow-Up StudiesHumansMiddle AgedPhlebographyPlethysmography, ImpedancePredictive Value of TestsProspective StudiesPulmonary EmbolismThrombophlebitis

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

2048047

Citation

Prandoni, P, et al. "Failure of Computerized Impedance Plethysmography in the Diagnostic Management of Patients With Clinically Suspected Deep-vein Thrombosis." Thrombosis and Haemostasis, vol. 65, no. 3, 1991, pp. 233-6.
Prandoni P, Lensing AW, Büller HR, et al. Failure of computerized impedance plethysmography in the diagnostic management of patients with clinically suspected deep-vein thrombosis. Thromb Haemost. 1991;65(3):233-6.
Prandoni, P., Lensing, A. W., Büller, H. R., Carta, M., Vigo, M., Cogo, A., Cuppini, S., & ten Cate, J. W. (1991). Failure of computerized impedance plethysmography in the diagnostic management of patients with clinically suspected deep-vein thrombosis. Thrombosis and Haemostasis, 65(3), 233-6.
Prandoni P, et al. Failure of Computerized Impedance Plethysmography in the Diagnostic Management of Patients With Clinically Suspected Deep-vein Thrombosis. Thromb Haemost. 1991 Mar 4;65(3):233-6. PubMed PMID: 2048047.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Failure of computerized impedance plethysmography in the diagnostic management of patients with clinically suspected deep-vein thrombosis. AU - Prandoni,P, AU - Lensing,A W, AU - Büller,H R, AU - Carta,M, AU - Vigo,M, AU - Cogo,A, AU - Cuppini,S, AU - ten Cate,J W, PY - 1991/3/4/pubmed PY - 1991/3/4/medline PY - 1991/3/4/entrez SP - 233 EP - 6 JF - Thrombosis and haemostasis JO - Thromb Haemost VL - 65 IS - 3 N2 - Before a new diagnostic modality can be introduced in clinical medicine, the validity of both a normal and abnormal test result have to be assessed prospectively in an appropriate patient group. We have evaluated the clinical validity of a new computerized impedance plethysmography (CIP) in the diagnostic management of 381 consecutive patients with clinically suspected venous thrombosis. In patients with serially normal CIP results, the diagnosis of venous thrombosis was refuted and, consequently, they were not treated with anticoagulant therapy and all were followed up for a period of 6 months to estimate the occurrence of symptomatic venous thromboembolism. The study was prematurely terminated by the safety monitoring committee because of an unacceptably high incidence of confirmed venous thromboembolism (10 patients, 3.2%; 95% confidence interval: 1.6% to 6%), including 4 episodes of fatal pulmonary embolism. In a subsequent explanatory study using ultrasonography in 29 other symptomatic patients who had at least 2 repeated normal CIP test results, the failure of CIP to detect proximal vein thrombosis was confirmed in 4 patients (14%). The reasons for this failure are probably related to the use of a modified device to measure impedance in the CIP apparatus, resulting in a lower ability to separate patients without venous thrombosis from those with the disease. We concluded that CIP is insensitive for the detection of proximal vein thrombosis and, therefore, not clinically useful in the diagnostic management of patients with suspected venous thrombosis. SN - 0340-6245 UR - https://www.unboundmedicine.com/medline/citation/2048047/Failure_of_computerized_impedance_plethysmography_in_the_diagnostic_management_of_patients_with_clinically_suspected_deep_vein_thrombosis_ DB - PRIME DP - Unbound Medicine ER -