Diagnosis of lower-extremity deep vein thrombosis in outpatients with musculoskeletal disorders: a national survey study of physical therapists.
BACKGROUND AND PURPOSE: Prompt identification of outpatients who may have proximal lower-extremity deep vein thrombosis (PDVT) is important, in part, because of the risk of pulmonary embolism. The purposes of our study were to determine the degree of accuracy of physical therapists' estimates of the...
| Published in: | Physical Therapy Vol. 84; no. 8; pp. 717 - 729 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Oxford University Press / USA
Aug2004
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106664217&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106664217 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00319023 PTH jtl: Physical Therapy issn: 00319023 maglogo: N pubinfo: dt: Aug2004 vid: 84 iid: 8 pid: 10398 pub: Oxford University Press / USA artinfo: ui: 106664217 2004186867 10.1093/ptj/84.8.717 NLM15283622 106664217 ppf: 717 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Diagnosis of lower-extremity deep vein thrombosis in outpatients with musculoskeletal disorders: a national survey study of physical therapists. aug: au: Riddle DL Hillner BE Wells PS Johnson RE Hoffman HJ Zuelzer WA affil: Professor, Dept of Physical Therapy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298-0224; dlriddle@vcu.edu sug: subj: Venous Thrombosis Diagnosis Physical Therapists Musculoskeletal Diseases Complications Ambulatory Care Clinical Competence Leg Blood Supply Outpatients Vignettes Decision Making, Clinical Referral and Consultation Utilization Surveys Confidence Intervals Random Sample Data Analysis Software Multiple Logistic Regression Intrarater Reliability Funding Source Human ab: BACKGROUND AND PURPOSE: Prompt identification of outpatients who may have proximal lower-extremity deep vein thrombosis (PDVT) is important, in part, because of the risk of pulmonary embolism. The purposes of our study were to determine the degree of accuracy of physical therapists' estimates of the probability of PDVT in hypothetical patient vignettes and to determine whether physical therapists would contact the referring physician about the hypothetical patients' condition as recommended in published evidence. SUBJECTS AND METHODS: A survey instrument consisting of 6 vignettes was sent to a nationally representative random sample of 1,500 physical therapists. The clinical decision rule developed by Wells and colleagues served as the gold standard for PDVT probability. RESULTS: A total of 969 (65% response rate) physical therapists completed the survey. We found no evidence of nonresponse bias. For the 2 high-probability vignettes, 87% and 64% of the physical therapists underestimated the probability of PDVT. For the 2 high-probability cases, 32% and 27% of the physical therapists reported that they would not have contacted the referring physician. For the 2 moderate-probability cases, 15% and 30% of the physical therapists would not have contacted the referring physician. Therapist experience, certification status, place of practice, and region of the country did not explain the findings. DISCUSSION AND CONCLUSION: The care of outpatients who are at risk for PDVT could potentially be improved by use of the clinical decision rule developed by Wells and colleagues, although more study is warranted. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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