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Computer algorithm compared with routine clinical practice in screening for deep venous thrombosis in the leg in an emergency department.

Abstract：

OBJECTIVE:To audit routine clinical practice in screening patients admitted to an accident and emergency department for deep venous thrombosis in the leg (DVT) and compare it with a computer algorithm. DESIGN:Retrospective study of case notes with data subsequently entered into a computer algorithm followed by a comparison of the diagnosis and recommended management from each modality. SETTING:Emergency department at a London teaching hospital. POPULATION OR SAMPLE:A convenience sample of 43 patients attending the emergency department. METHODS:Evaluation of clinical notes for completeness of assessment and correct diagnosis; entry of the same data into the computer algorithm. MAIN OUTCOME MEASURES:Completeness of data collection, diagnosis of presence or absence of DVT, and recommended therapy. RESULTS:The Wells score was missing in the clinical evaluation in 60% of cases. Clinicians relied primarily on the results of ultrasound scans and in six cases the absence of required D-Dimer measurements meant that the algorithm stalled. Clinical and algorithm analysis and recommendations were not compliant in 10 cases (23%). CONCLUSIONS:Clinical assessment of potential DVT in the accident and emergency department is poorly performed when compared with a computerised algorithm. Clinicians rely heavily on scan reports rather than clinical assessment which may have cost implications.

journal_name

Comput Methods Programs Biomed

journal_title

Computer methods and programs in biomedicine

authors

Steer P,Nader A,Ostler A,Malik O,Prior R,Scurr J

doi

10.1016/j.cmpb.2019.105046

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

105046

eissn

0169-2607

issn

1872-7565

pii

S0169-2607(18)31316-6

journal_volume

182

pub_type

杂志文章

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