Nurse-led Compression Ultrasound for Diagnosis of lower limb DVT
Research type
Research Study
Full title
Nurse-led compression ultrasound for the diagnosis of acute lower limb deep vein thrombosis at the point-of-care
IRAS ID
274065
Contact name
Ashley Matthies
Contact email
Sponsor organisation
Homerton University Hospital
Duration of Study in the UK
1 years, 6 months, 0 days
Research summary
Background.
Suspected lower limb deep vein thrombosis (DVT) represents a significant number of attendances to the Emergency Department (ED). Current diagnostic pathways involve risk stratification and possible referral to an urgent clinic for duplex ultrasound. A number of patients receive repeated doses of low molecular weight heparin (LMWH) prior to diagnosis and have to return to hospital for definitive imaging which is inconvenient, costly and potentially unsafe. In addition to this, only 15-20% of these patients have a final diagnosis of DVT. Evidence suggests that ED physicians can perform compression ultrasound (CUS) with a high degree of accuracy on the same day of attendance obviating the problems outlined above.Aims.
The primary aim of this study is to determine the test characteristics of CUS for the diagnosis of DVT when performed by ED nurse practitioners. Secondary outcomes include the potential reduction in referrals for imaging and follow-up and the reduction of doses of LMWH received by patients.Methods.
This is a prospective cross-sectional study and diagnostic test assessment of ED-nurse practitioner performed CUS compared to standard outpatient duplex ultrasound. Consecutive patients meeting the inclusion criteria will be recruited. A priori sample size calculation has been performed.Importance of study.
Results may inform the design of a ‘one-stop’ diagnostic pathway for lower limb DVT in the ED. The results would be generalisable to the United Kingdom, and could result in efficiency savings, a new revenue stream for the ED, improved compliance with NICE guidance and a reduction in the number of unnecessary doses of LMWH. This would be the first study investigating performance of nurse practitioner-performed CUS.REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
20/LO/1017
Date of REC Opinion
29 Oct 2020
REC opinion
Further Information Favourable Opinion