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From Joshua Steinberg, MD:
The gold standard diagnostic tests for DVT and PE are invasive venography and invasive pulmonary angiography (and autopsy). These tests are invasive, time consuming, technically challenging, and sometimes not feasible for a highly ill patient. No single alternative test alone is quicker, easier, less invasive, and as accurate. But combinations of tests starting with clinical scoring systems for pretest probability followed by sequential labwork and imaging can almost always do the job. The only problem is that the algorithms involved are very hard to memorize and keep straight. That's where a point-of-care guide like this comes in. The app offers 1 algorithm for DVT diagnosis and 2 algorithms for PE diagnosis, as well as discussion of diagnostic approach and workup of hypercoagulable state. The app addresses such common questions as: * what are the Wells clinical criteria and scoring systems for DVT and PE? * in which situations will a D-dimer alone rule out DVT? how about PE? * how can I use the rarely definitive VQ scan to diagnose PE, and what other tests might I need to use along with it? * what tests make sense to order when investigating for a hypercoagulable state, and when should I do them?This app is written and intended for practicing clinicians like internists, hospitalists, family physicians, ER and urgent care docs; for resident physician trainees; and for medical students. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.