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ARTICLE |

Diagnosis of Deep Vein Thrombosis:  Using the Right Test for the Right Purpose

H. Brownell Wheeler, MD
Arch Intern Med. 1991;151(11):2145-2146. doi:10.1001/archinte.1991.00400110009001.
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In this issue of the ARCHIVES, Agnelli et al1 point out the need for an accurate noninvasive test for deep vein thrombosis (DVT) in patients undergoing hip surgery. Impedance plethysmography (IPG) has proved accurate for many patient groups, and so these authors studied the use of IPG in asymptomatic patients after hip surgery. Using an Italian impedance plethysmography and scoring method, they report poor diagnostic accuracy and conclude that routine venography is still required. Despite the negative results, this article is of interest because it points out the need to discriminate between patient groups when using diagnostic tests for DVT. The utility of different tests varies with the clinical situation, and it is important to use tests that have been validated for the purpose employed.

Few North American investigators use IPG for screening asymptomatic hip surgery patients. Most advocate ultrasonic imaging or venography.2-4 It has long been recognized

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