Exclusion and Diagnosis of Deep Vein Thrombosis by a Rapid ELISA D-dimer Test, Compression Ultrasonography, and a Simple Clinical Model

Summary: The classical clinical signs of deep vein thrombo-sis (DVT) are unspecific and may be found in several other conditions besides DVT. Therefore, patients suspicious of DVT are subjected to elaborate invasive or noninvasive evidence-based procedures that actually confirm DVT in only 20 % to 30 % of patients in this setting. However, simple laboratory tests and noninvasive strategies to exclude and diagnose DVT are becoming available in the clinical emergency setting of outpatients. In the presented literature, a sound basis is pro-vided for quantifying clinical judgment for the diagnosis of acute proximal DVT. The number of positive clinical findings at time of first suspicion of DVT appears to correlate directly with the probability of acute proximal DVT. The modified clinical model of Landefeld and Wells for DVT allows reason-able accurate classification of patients into low, moderate, an