Quality statement 2: Diagnosis of deep vein thrombosis

Quality statement

People with suspected deep vein thrombosis have all diagnostic investigations completed within 24 hours of first clinical suspicion.

Rationale

It is important that all diagnostic investigations for suspected deep vein thrombosis (DVT) are completed within 24 hours to ensure prompt treatment if the diagnosis is confirmed, and to avoid unnecessary repeat doses of anticoagulants if the diagnosis is excluded.

Quality measure

Structure: Evidence of local arrangements to ensure people with suspected DVT have all diagnostic investigations completed within 24 hours of first clinical suspicion.

Process: The proportion of people who have all diagnostic investigations completed within 24 hours of first clinical suspicion.

Numerator – the number of people in the denominator who have all diagnostic investigations completed within 24 hours of first clinical suspicion.

Denominator – the number of people with suspected DVT.

Outcome: Incidence of pulmonary embolism (PE) in people who have undergone all diagnostic tests for DVT.

What the quality statement means for each audience

Service providers ensure systems are in place for people with suspected DVT to have all diagnostic investigations completed within 24 hours of first clinical suspicion.

Healthcare professionals ensure people with suspected DVT have all diagnostic investigations completed within 24 hours of first clinical suspicion.

Commissioners ensure they commission services for people with suspected DVT to have all diagnostic investigations completed within 24 hours of first clinical suspicion.

People who may have deep vein thrombosis have all their diagnostic tests done within 24 hours of the tests being requested by an appropriate healthcare professional.

Source guidance

NICE guideline CG144 recommendations 1.1.1 (key priority for implementation), 1.1.2, 1.1.3 (key priority for implementation), 1.1.4 (key priority for implementation) and 1.1.14. See also the diagnostic algorithms in NICE guideline CG144 appendix C.

Data source

Structure: Local data collection.

Process: Local data collection.

Outcome: Local data collection.

Definitions

Suspected DVT

NICE guideline CG144 recommendations 1.1.1 and 1.1.2 describe the features of suspected DVT and how to estimate clinical probability (two‑level DVT Wells score).

Diagnostic investigations completed are outlined in the diagnostic algorithms in NICE guideline CG144 appendix C.

NICE guideline CG144 recommendations 1.1.3 and 1.1.4 recommend arranging diagnostic testing for people with suspected DVT according to clinical probability.

First clinical suspicion Clinical suspicion of DVT by an appropriate healthcare professional in community or hospital settings.