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October 3, 1977

Deep Venous Thrombosis

JAMA. 1977;238(14):1502. doi:10.1001/jama.1977.03280150072026

To the Editor.—  In the introduction to their paper on the diagnosis of clinically suspected deep venous thrombosis (DVT) of the lower extremities" (237:2195, 1977), Moser, Brach, and Dolan indicate that they studied impedance plethysmography (IPG) and fibrinogen125I uptake (FUT) in comparison with venography so as to determine their "relative value." They concluded that IPG and FUT tests "can assist physicians in the diagnosis of clinically suspected DVT."Their own results show that each of the tests has a false-negative rate in excess of 20%, rates similar to comparable studies.1,2 They have failed to grasp this: has a test with an accuracy 20% less than venography any place at all in the management of suspected DVT? We consider that it has no place. The risks both of needless anticoagulation and of untreated DVT are substantial, and we should not accept undependable tests.Furthermore, it is not acceptable