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To the Editor: In their randomized controlled trial, Dr Bernardi and colleagues¹ found equivalent safety for 2 ultrasound-based diagnostic strategies for managing outpatients with suspected deep vein thrombosis (DVT). The results of the study deserve some comments.

First, for the 2-point strategy the prevalence of proximal DVT detection on the second ultrasound test was 5.5% (14/256). This is much higher than has been previously reported. For example, in the study by Cogo et al,² which included more than 1700 patients with suspected DVT, this rate was less than 1%.² It has been suggested that the second ultrasound test is of limited added value, and strategies have been proposed using a single proximal venous examination, which proved to have an acceptable 3-month thromboembolic rate.³ However, the use of a single proximal vein ultrasonography might be criticized if the prevalence of proximal DVT detected at the second ultrasound test is as high . . . [Full Text of this Article]

Isabelle Quere, MD
isabelle.queree@wanadoo.fr
Montpellier University Hospital
Montpellier, France

Marc Righini, MD
Geneva University Hospital
Geneva, Switzerland

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