C.1Review protocol – DVT diagnosis (clinical scores)

Review questionIn people with suspected DVT, what is the effectiveness of clinical scores in ruling out deep vein thrombosis?
ObjectivesTo estimate the diagnostic accuracy of clinical scores.
Criteria for considering studies for the review
Study designRandomised controlled trials and prospective diagnostic studies. Reference standard to be tested at same time as the intervention.
Patients with suspected DVT
PopulationConsecutive patients with suspected DVT
InterventionClinical scores
ComparisonD-dimer, venography, ultrasound, labelled fibrogen uptake.
OutcomesSensitivity, specificity, NPV, PPV, 3 month VTE rate, mortality.
EqualitiesNone reported
How the information will be searched
Search strategy
The databases to be searched are Medline, Embase, The Cochrane Library and CINAHL.
Studies will be restricted to English language only
No date restriction will be applied. Databases will be searched from their date of origin.
The review strategyClinical scores to be considered were the Wells scores, both the newer and older versions, hospital based score, clinical prediction/suspicion, prediction rules and validated rules.

2 stage or combination studies were considered.

Studies were excluded if they were:
  • Summaries or reviews
  • population incorrect
  • Retrospective
  • Reference standard not given to all patients
  • Not the reference question
Meta-analysis will not be conducted for diagnostic studies. Ranges of results will be reported.

If there is heterogeneity the following sub-group analysis should be performed: dates of study and types of scans.

From: Appendix C, Review protocols

Cover of Venous Thromboembolic Diseases
Venous Thromboembolic Diseases: The Management of Venous Thromboembolic Diseases and the Role of Thrombophilia Testing [Internet].
NICE Clinical Guidelines, No. 144.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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