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The purpose of this study was to determine the most appropriate laboratory and clinical criteria for the diagnosis of acute deep vein thrombosis (DVT). A patient was considered to have an acute DVT if he had a positive test result and signs or symptoms of DVT with a reference range of duplex ultrasound velocity 1.40-4.00 m/sec. Two hundred and ninety-seven patients with signs and/or symptoms of DVT were enrolled in the study. Of these patients, 19 had pulmonary embolism, 13 had a venous limb phlebogram and 20 had subclavian venography. Only 150 patients had both initial leg ultrasonography and duplex velocimetry. Thirty-two patients were found to have acute DVT (14/19 with pulmonary embolism, 12/13 with venous phlebogram and 6/20 with subclavian venography). Of the 125 patients without acute DVT, 24 were diagnosed as having DVT on the basis of clinical signs and symptoms. Overall, the diagnostic accuracy (89%) of clinical criteria for acute DVT was similar to the diagnostic accuracy (86%) of ultrasonography criteria. The positive predictive value for clinical criteria was 72% and the negative predictive value was 91%. The absence of clinical signs and symptoms in patients with acute pulmonary embolism or no DVT was highly sensitive but resulted in a lower positive predictive value (66%) and a lower negative predictive value (87%). No single clinical criteria was superior to others in achieving a high diagnostic accuracy for the diagnosis of acute DVT.Two scoliosis brace design modalities compared.
This study compares two brace design modalities, the temporary plastic and the rigid foam. Both brace modalities have a standard three-point pressure suit, but the plastic cover is custom-fitted. The unbridled comparison in this study is that between the plastic cover
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