PMID- 15283622
OWN - NLM
STAT- MEDLINE
DCOM- 20041005
LR  - 20181130
IS  - 0031-9023 (Print)
IS  - 0031-9023 (Linking)
VI  - 84
IP  - 8
DP  - 2004 Aug
TI  - Diagnosis of lower-extremity deep vein thrombosis in outpatients with 
      musculoskeletal disorders: a national survey study of physical therapists.
PG  - 717-28
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.
FAU - Riddle, Daniel L
AU  - Riddle DL
AD  - Department of Physical Therapy, Medical College of Virginia Campus, Virginia 
      Commonwealth University, Richmond, VA 23298-0224, USA. dlriddle@vcu.edu
FAU - Hillner, Bruce E
AU  - Hillner BE
FAU - Wells, Philip S
AU  - Wells PS
FAU - Johnson, Robert E
AU  - Johnson RE
FAU - Hoffman, Heather J
AU  - Hoffman HJ
FAU - Zuelzer, Wilhelm A
AU  - Zuelzer WA
LA  - eng
GR  - R03 HS13059-01/HS/AHRQ HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Phys Ther
JT  - Physical therapy
JID - 0022623
SB  - IM
MH  - *Ambulatory Care
MH  - *Clinical Competence
MH  - Humans
MH  - Leg/*blood supply
MH  - Logistic Models
MH  - Musculoskeletal Diseases/*complications
MH  - *Physical Therapy Specialty
MH  - Professional Practice Location
MH  - Referral and Consultation/statistics & numerical data
MH  - Surveys and Questionnaires
MH  - United States
MH  - Venous Thrombosis/*diagnosis
EDAT- 2004/07/31 05:00
MHDA- 2004/10/06 09:00
CRDT- 2004/07/31 05:00
PHST- 2004/07/31 05:00 [pubmed]
PHST- 2004/10/06 09:00 [medline]
PHST- 2004/07/31 05:00 [entrez]
PST - ppublish
SO  - Phys Ther. 2004 Aug;84(8):717-28.