Interobserver reliability of compression ultrasound for residual thrombus after first unprovoked deep vein thrombosis.
J Thromb Haemost. 2012 Jun 23;
Authors: Tan M, Bornais C, Rodger M
Background:Ã¢ÂÂAccurate assessment of residual thrombosis is of clinical importance for diagnostic baseline imaging and may be of value in risk stratification for recurrent venous thromboembolism (VTE). This study evaluated the interobserver reliability of the measurement of residual thrombosis in patients six months after a first unprovoked deep vein thrombosis (DVT) of the leg. Patients/Methods:Ã¢ÂÂAll enrolled patients received two ultrasound examinations by two independent blinded ultrasound technicians 5-7 months after their first unprovoked DVT. In total 49 patients completed the two baseline ultrasound examinations. During the examinations the presence of residual thrombosis was evaluated. In case residual thrombosis was present, a detailed description about the size and location was reported. After all ultrasound results were collected, the interobserver agreement was calculated by the kappa statistics, Pearson correlation and the Bland-Altman plot. Furthermore the clinical implications of interobserver reliability were examined. Results:Ã¢ÂÂThe interobserver reliability of the assessment whether residual thrombosis is present is very good (ÃÂº=0.92). The interobserver reliability of the measurement of residual thrombosis is good (r(2) =0.648) with limited patients being misclassified. For the assessment of the percentage of residual occlusion the interobserver reliability was fair (r(2) =0.357). Conclusions:Ã¢ÂÂOur results suggest that interobserver reliability of measuring residual thrombosis is high and that the variability introduced by interobserver reliability has minimal clinical implications. Our study is important for the use of baseline imaging for the diagnostic and prognostic management of recurrent VTE. ÃÂ© 2012 International Society on Thrombosis and Haemostasis.
PMID: 22726359 [PubMed - as supplied by publisher]