SHM Converge Scientific Abstract ePoster Gallery-Diagnostic Yield of Imaging for Venous Thromboembolism: Results From a Population-Health Database

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This study evaluated how often imaging for deep vein thrombosis (DVT) and pulmonary embolism (PE) actually found disease in a large U.S. claims database. Using the Optum Clinformatics Data Mart, researchers reviewed more than 1.5 million visits with Doppler ultrasound for suspected DVT and 710,263 visits with chest CT angiography or V/Q scans for suspected PE between October 2015 and June 2019.<br /><br />Overall diagnostic yield was low: DVT was found in 9.8% of imaging visits and PE in 12.7%. In emergency, inpatient, and outpatient settings, most tests were negative as well. DVT positivity was 10.4% in the ER, 16.9% inpatient, and 6.5% outpatient; PE positivity was 6.4%, 18.7%, and 8.8%, respectively.<br /><br />The study also identified patient factors linked to low or high yield. For DVT imaging, low yield was associated with female sex, prior VTE, and varicose veins, while higher yield was associated with cancer, central venous access, and thrombophilia. For PE imaging, low yield was associated with Asian race, prior VTE, and acute infection, while higher yield was associated with thrombophilia, respiratory failure, and heart failure/acute myocardial infarction.<br /><br />The authors conclude that imaging for suspected VTE is negative in at least 8 to 9 out of 10 cases, especially in ER and outpatient settings. They suggest more judicious ordering of imaging, particularly in patients with prior VTE, and emphasize the need for better biomarkers and decision tools to improve pretest probability assessment. Limitations include the use of claims data and lack of symptom-level clinical detail.

Asset Subtitle

Nidhi Rohatgi

Meta Tag

Author List Alex Dahlen, Max Wintermark, Neera Ahuja, Nidhi Rohatgi, Yingjie Weng

Category Research

Concept Deep Vein Thrombosis

Concept Pulmonary Embolism

Concept Diagnostic Imaging Yield

Concept Negative Imaging Study

Concept Retrospective Cohort Study

Distinguished Non-Finalist

Presenter Organization Stanford University School of Medicine

Presenting Author Nidhi Rohatgi

Track Outcomes Research

Keywords

deep vein thrombosis

pulmonary embolism

imaging yield

Doppler ultrasound

CT angiography

V/Q scan

venous thromboembolism

claims database

pretest probability

diagnostic imaging

Deep Vein Thrombosis

Pulmonary Embolism

Diagnostic Imaging Yield

Negative Imaging Study

Retrospective Cohort Study