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Titolo:
Optimal management strategy for use of compression US for deep venous thrombosis in symptomatic patients: A cost-effectiveness analysis
Autore:
Kim, HM; Kuntz, KM; Cronan, JJ;
Indirizzi:
Univ Michigan, Ctr Stat Consultat & Res, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 ultat & Res, Ann Arbor, MI 48109 USA Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 olicy & Management, Boston, MA 02115 USA Brown Univ, Sch Med, Rhode Isl Hosp, Dept Diagnost Imaging, Providence, RI02912 USA Brown Univ Providence RI USA 02912 gnost Imaging, Providence, RI02912 USA
Titolo Testata:
ACADEMIC RADIOLOGY
fascicolo: 2, volume: 7, anno: 2000,
pagine: 67 - 76
SICI:
1076-6332(200002)7:2<67:OMSFUO>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
VEIN THROMBOSIS; IMPEDANCE PLETHYSMOGRAPHY; DECISION-ANALYSIS; DIAGNOSIS; ULTRASONOGRAPHY; OUTPATIENTS; ULTRASOUND; ACCURACY; HEPARIN; HEALTH;
Keywords:
cost effectiveness; thrombosis, US; veins, thrombosis; veins, US;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Kuntz, KM Univ Michigan, Ctr Stat Consultat & Res, 3514 Rackham, Ann Arbor, MI 48109USA Univ Michigan 3514 Rackham Ann Arbor MI USA 48109 r, MI 48109USA
Citazione:
H.M. Kim et al., "Optimal management strategy for use of compression US for deep venous thrombosis in symptomatic patients: A cost-effectiveness analysis", ACAD RADIOL, 7(2), 2000, pp. 67-76

Abstract

Rationale and Objectives. The authors' purpose was to identify the optimalstrategy for using compression ultrasonography (US) in patients suspected of having deep venous thrombosis (DVT). Materials and Methods. The authors developed a decision-analytic model representing the natural history of DVT and the benefits and risks of anticoagulation therapy. They evaluated six initial imaging strategies: (a) unilateral examination of the common femoral and popliteal veins; (b) unilateral examination of the common femoral, popliteal, and femoral veins; (c) bilateral examination of the common femoral and popliteal veins; (d) bilateral examination of the common femoral, popliteal, and femoral veins; (e) complete unilateral examination of the symptomatic leg (including calf veins); and (f) complete bilateral examination of both legs. Results. For 65-year-old men with unilateral symptoms of DVT, the most effective strategy was bilateral examination of the common femoral and popliteal veins with anticoagulation therapy in patients with proximal DVT and follow-up bilateral examination of the common femoral and popliteal veins in patients without an initial diagnosis of DVT, with an incremental cost-effectiveness ratio of $39,000 per quality-adjusted life year gained. Conclusion. These results suggest that bilateral examination limited to the common femoral and popliteal veins, with follow-up bilateral examination limited to the common femoral and popliteal veins, was as cost-effective asother well-accepted medical interventions. The results were sensitive to the distribution of clot, diagnostic accuracy of compression US, and probability of bleeding with long-term morbidity.

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Documento generato il 05/04/20 alle ore 03:37:57