Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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GUIDELINE
Year : 2015  |  Volume : 10  |  Issue : 1  |  Page : 3-15

The Saudi clinical practice guideline for the diagnosis of the first deep venous thrombosis of the lower extremity


1 Department of Intensive Care, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs Jeddah, Saudi Arabia
2 Department of Radiology, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
3 Department of Medicine, King Fahad General Hospital, Jeddah, Saudi Arabia
4 Department of Medicine, King Fahad Medical City, Ministry of Health, Riyadh, Saudi Arabia
5 Department of Surgery, Um Al Qura University, Makkah, Saudi Arabia
6 Department of Pathology, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
7 Department of Medicine, King Abdulaziz Medical City, Riyadh, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
8 King Saud University, Saudi Arabia
9 Department of Clinical Epidemiology and Biostatistics; Department of Medicine, McMaster University, Hamilton, Canada
10 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Internal Medicine and Nephrology, University of Missouri-Kansas City, Kansas City, Missouri, United States
11 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada;Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil

Correspondence Address:
Fahad Al-Hameed
Chairman of the Saudi Association for Venous-Thrombo-Embolism (SAVTE), Department of Intensive Care, College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences KSAU-HS, King Abdul-Aziz Medical City, National Guard Health Affairs, Jeddah
Saudi Arabia
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Source of Support: This clinical practice guideline was funded by the Ministry of Health, Saudi Arabia,, Conflict of Interest: Ebtisam Bakhsh, Hasan M Al Dorzi, and Essam Aboelnazar re-ceived payment as speakers and research grants for issues related to treatment of venous throm-boembolism.

DOI: 10.4103/1817-1737.146849

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DOI: 10.4103/1817-1737.146849

Rights and Permissions

The diagnosis of deep venous thrombosis (DVT) may be challenging due to the inaccuracy of clinical assessment and diversity of diagnostic tests. On one hand, missed diagnosis may result in life-threatening conditions. On the other hand, unnecessary treatment may lead to serious complications. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia (KSA), an expert panel led by the Saudi Association for Venous Thrombo-Embolism (SAVTE; a subsidiary of the Saudi Thoracic Society) with the methodological support of the McMaster University Working Group, produced this clinical practice guideline to assist healthcare providers in evidence-based clinical decision-making for the diagnosis of a suspected first DVT of the lower extremity. Twenty-four questions were identified and corresponding recommendations were made following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. These recommendations included assessing the clinical probability of DVT using Wells criteria before requesting any test and undergoing a sequential diagnostic evaluation, mainly using highly sensitive D-dimer by enzyme-linked immunosorbent assay (ELISA) and compression ultrasound. Although venography is the reference standard test for the diagnosis of DVT, its use was not recommended.


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