![]() Many patients will receive unnecessary anticoagulants with numerous potential side-effects through an often-painful subcutaneous injection whilst waiting more than the recommended four hours for their scan. Between 85 and 90% of patients presenting to their GP in high-income countries with a suspected DVT will be investigated only to find no evidence of a thrombus 5. ![]() Ultrasound scans are most commonly performed in a radiology or cardiovascular department of a hospital by a highly trained radiographer/radiologist.Ĭurrently, no reliable test is available that can be used in a general healthcare setting (GP practice, community hospital, on a hospital ward) or be used remotely at the point of care (nursing home, patient’s home). In high-income countries, the routine practice to diagnose patients after a positive D-dimer blood test and an indicative evaluation using the Wells score 6 is to confirm or rule out a suspected DVT with a two- or three-point ultrasound scan. 30–50% of the surviving patients develop long-term symptoms in their affected leg (post-thrombotic syndrome) 5. Mortality from VTE is common, a European study estimated 534,000 deaths per year 3 and a similar study in the US reported 300,000 deaths per year 4. An ageing population across many countries will lead to a greater health burden, particularly in middle- and low-income countries where early death from infection is decreasing. Using these estimates, and using the most conservative incidence figure, globally at least 7.7 million people will require investigation for VTE every year. VTE, deep vein thrombosis (DVT) and pulmonary embolus (PE) are the leading cause of hospital-related disability-adjusted life years lost 2. Worldwide, the incidence of VTE is 1– individuals, rising to 2– in individuals aged over 70 years, and 3– in those over 80 years 1. Venous thromboembolism (VTE) is associated with a major global burden of disease. Our approach is estimated to generate a positive net monetary benefit at costs up to £72 to £175 per software-supported examination, assuming a willingness to pay of £20,000/QALY. To assess the potential benefits of this technology in healthcare we evaluate the entire clinical DVT decision algorithm and provide cost analysis when integrating our approach into diagnostic pathways for DVT. Algorithmic DVT diagnosis performance results in a sensitivity within a 95% CI range of (0.82, 0.94), specificity of (0.70, 0.82), a positive predictive value of (0.65, 0.89), and a negative predictive value of (0.99, 1.00) when compared to the clinical gold standard. We train a deep learning algorithm on ultrasound videos from 255 volunteers and evaluate on a sample size of 53 prospectively enrolled patients from an NHS DVT diagnostic clinic and 30 prospectively enrolled patients from a German DVT clinic. Our method provides guidance for free-hand ultrasound and aids non-specialists in detecting DVT. We collect images in a pre-clinical study and investigate a deep learning approach for the automatic interpretation of compression ultrasound images. Thus, diagnosis at the point of care by non-specialists is desired. However, many patients with possible symptoms are not found to have a DVT, resulting in long referral waiting times for patients and a large clinical burden for specialists. Compression ultrasound of the legs is the diagnostic gold standard, leading to a definitive diagnosis. Deep vein thrombosis (DVT) is a blood clot most commonly found in the leg, which can lead to fatal pulmonary embolism (PE).
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