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Kent L. Richards, MD; John D. Armstrong, Jr, MD; Gerasim Tikoff, MD; Edward J. Hershgold, MD; Jeffrey L. Booth, MD; Jack B. Rampton, MD

Arch Intern Med. 1976;136(10):1091-1096.

Abstract
Eighty-five patients suspected of having lower-extremity deep venous thrombosis (DVT) participated in a prospective study to test the diagnostic accuracy of four noninvasive techniques: Doppler ultrasonic flow study, electrical impedance plethysmography, the serial dilution protamine sulfate test, and an extensive physical examination. Ascending radiocontrast phlebography was the diagnostic standard of reference. We found that (1) when both Doppler and impedance examinations were positive, the diagnosis of DVT could be considered virtually certain; (2) impedance and Doppler examinations, when used in combination, were reliable screening tests capable of establishing or excluding the presence of thigh DVT; (3) physical examination and the serial dilution protamine sulfate test were unreliable screening techniques for DVT; (4) techniques other than the noninvasive methods investigated were needed to reliably detect or to exclude popliteal and calf DVT.

(Arch Intern Med 136:1091-1096, 1976)

Author Affiliations
From the Veterans Administration Hospital (Drs Richards, Armstrong, Tikoff, and Rampton), and the University of Utah College of Medicine (Drs Richards, Armstrong, Tikoff, Hershgold, Booth, and Rampton), Salt Lake City.

Footnotes
Received for publication Sept 12, 1975; accepted March 19, 1976.

Reprint requests to Medical Service, VA Hospital, 500 Foothill Dr, Salt Lake City, UT 84113 (Dr Tikoff).

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