Talk:Deep vein thrombosis

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Good articleDeep vein thrombosis has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
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merge[edit]

I think the merge should have been done the other way. The term "deep vein thrombosis" is more common than "deep venous thrombosis"

google results:
633,000 for deep vein thrombosis
358,000 for deep venous thrombosis
Nephron 01:08, 21 July 2005 (UTC)

The term in medical literature appears to be venous. JFW | T@lk 08:18, 21 July 2005 (UTC)
Based on what?
Pubmed results:
deep vein thrombosis: 31302
deep

Since an important audience is the less-technical, the common usage is more helpful. Technical readers, if they wish to consult Wikipedia, will be familiar with the more common term. —Preceding unsigned comment added by 67.101.66.55 (talk) 04:22, 30 November 2007 (UTC)

broken internal reference[edit]

"A careful history has to be taken considering risk factors (see below), " There's no subsection entitled 'Risk factors'. Could this be clarified or corrected?

Merging with thrombophlebitis[edit]

Of thrombophlebitis and deep vein thrombosis, the latter is the more serious and clinically relevant ones. Perhaps thrombophlebitis could be mentioned within deep vein thrombosis. Furthermore the content on thrombophlebitis is quite similar to the DVT article. Andrew73 12:33, 15 March 2006 (UTC)

I would say that they're distinct enough to justify separate articles (DVT is a spontaneous clot usually of the deep leg veins without inflammation, whereas thrombophlebitis is an inflamed clot usually of the superficial arm veins and usually after an IV). Under pressure, I suppose you could merge them into a general "Venous thrombotic conditions" page, but I don't think it makes sense to lump thrombophlebitis under DVT. I do, however, agree with your other comments, and certainly cleaning up the content of thrombophlebitis might clear up some of the confusion.  — JVinocur (talk • contribs) 00:35, 10 May 2006 (UTC)
Fair enough, but agree that the content of thrombophlebitis needs to be more focused on the superficial variety as that's the context that it's generally used. Andrew73 14:53, 10 May 2006 (UTC)

Confusing terminology[edit]

Prophylaxis? Pathogenesis? This article is hard to follow for the average lay person such as myself. Can someone rewrite with sections named "Causes" and "Treatment"? -- Barrylb 19:51, 6 May 2006 (UTC)

Complications[edit]

A complications section could be useful.

Possible ambiguity[edit]

"In up to 25% of all hospitalized patients, there may be some form of DVT, which often remains clinically inapparent." This presumably refers to all patients hospitalized for whatever reason, not all patients hospitalized for suspected DVT - the sentence logic suggests it must be the the former, but it's such a large statistic that it took me a couple of rereads to understand. Moonlander69 23:17, 1 June 2007 (UTC)

Pregnancy[edit]

Can someone please explain the risks of using the prescibed medications for DVT and pregnancy. And if I have DVT due to an previous pregnancy what should I do when pregnant again whilst having DVT.

Too "doctorish" and uses too much lingo[edit]

I think the article is way too complex and written in the lingo that doctors use, probably BY a doctor or someone with a lot of medical training. That's OK if they have that training, but the thing is that most of us regular every-day people can't understand it because we don't have that training.

Which parts do you find confusing? I agree that we need to make this content accessible. JFW | T@lk 22:06, 22 November 2007 (UTC)

Cause / Etiology[edit]

Besides the grammar being incorrect in the following sentence, it also seems to reference research that claims the opposite of what it says here.

Other risk factors include advanced age, obesity, infection, immobilization, female sex, use of combined (estrogen-containing) forms of hormonal contraception, tobacco usage and air travel ("economy class syndrome", a combination of immobility and relative dehydration) are some of the better-known causes.and references Tsai A et a (2002). "Cardiovascular risk factors and venous thromboembolism incidence etc." [1].

In the abstract states: RESULTS: Cigarette smoking, hypertension, dyslipidemia, physical inactivity, and alcohol consumption were not associated with risk of VTE.

So although these are the "better-known" causes, that particular research found that it was not associated? Deadstar 13:30, 20 September 2007 (UTC)

--The "physical inactivity" relates to, e.g., how much exercise a person does per week. But "immobilization" refers to a person on a plane, etc. I suppose the two would overlap in the case of a sickly, bed-bound person. Kenmcl2 (talk) 05:44, 12 February 2009 (UTC)

Prophylaxis in medical patients[edit]

This is again supported by a systematic review: doi:10.1111/j.1538-7836.2007.02847.x JFW | T@lk 22:07, 22 November 2007 (UTC)

Tim Russert 1950 - 2008[edit]

Tim Russert from MSNBC Meet The Press just passed because of DVT. He collapsed on his job just after returning from Italy. AugustinMa (talk) 21:35, 13 June 2008 (UTC)

Long flight DVT prevention[edit]

Apparently, DVT is common after long flights (see Tim Russert above). Can the article add a section about prevention measure before, during and just after a long flight. Thanks AugustinMa (talk) 21:35, 13 June 2008 (UTC)

Inconsistency with published death rate[edit]

The article says: "DVTs occur in about 1 per 1000 persons per year. About 1-5% will die from the complications".

Yet this link http://ap.google.com/article/ALeqM5jLUJgboI9vrUtwrpyeOXkWNLOFOQD937BUI80 gives much higher death number: "the new surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die". It implies 15-30% death rate. —Preceding unsigned comment added by 97.116.53.139 (talk) 03:14, 16 September 2008 (UTC)

The number in the hundreds of thousands is for venous thromboembolism, which means DVT + PE. DVT alone doesn't kill. Biosthmors (talk) 19:40, 19 April 2012 (UTC)

LMWH better?[edit]

This is going to get interesting: LMWH therapy instead of warfarin was well tolerated but improved outcomes for postthrombotic syndrome and leg ulcers. doi:10.1016/j.amjmed.2008.12.023 JFW | T@lk 20:39, 28 July 2009 (UTC)

Diagnostic review[edit]

Br J Haem doi:10.1111/j.1365-2141.2009.07732.x JFW | T@lk 21:03, 28 July 2009 (UTC)

Material typo at Wells criteria[edit]

I'm not medical or nursing, so I have not corrected the wording at Wells criterion 8, which currently reads as "major surgery requiring regional or general anesthetic in past 4 weeks". Surely that is a typo for "12 weeks". Patrick Hamilton (talk)

Yep. Just read this comment and I happened to fix that yesterday as I was going through the diagnosis section. Biosthmors (talk) 19:38, 19 April 2012 (UTC)

Management--Anticoagulation[edit]

The last sentence is a fragment and it is unclear to me what exactly is not being disputed: "Despite the fact that no one disputes this, based on a meta analysis done by the Cochrane Collaboration where they found only one randomized trial of anti coagulation vs placebo in the treatment of VTE in which there was no significant difference between the two." —Preceding unsigned comment added by 64.149.52.154 (talk) 21:29, 18 May 2010 (UTC)

Rewritten. Biosthmors (talk) 19:41, 19 April 2012 (UTC)

Merge[edit]

Traveller's thrombosis should be merged her as it is basically a DVT due to flight. It is the same disease just has some social significance. Doc James (talk · contribs · email) 00:59, 29 May 2011 (UTC)

Image[edit]

I think the image used in the info box is confusing, mostly because of the arrow which appears to point to the thrombus on the leg rather than in it. Is there a similar image without the arrow, under which it could be written something along the lines of "DVTs typically present with a swollen painful calf, and comparing the calf diameters is an integral part of the diagnosing of the syndrome (see right calf)."--Mofs (talk) 21:15, 30 July 2011 (UTC)

Changed to in. I do have a copy of the image without the arrow but hopefully the text change clears things up.--Doc James (talk · contribs · email) 21:49, 30 July 2011 (UTC)

Raising legs.[edit]

Please, please, please, someone knowledgeable on the mainstream medical approaches find references to my paragraph about raising legs. Raising legs does work and is often advised by medical practitioners. Anonywiki (talk) 21:54, 1 August 2011 (UTC)

I have never seen evidence for this. Would be happy to look at any you come across though. Review articles are best. Cheers Doc James (talk · contribs · email) 15:19, 8 October 2011 (UTC)

I removed a few items from the lead[edit]

I removed them,[2] as medical conditions which may lead to DVT because they aren't mentioned/sourced in the article. Instead, I added things that were sourced. Biosthmors (talk) 20:28, 27 February 2012 (UTC)

Nephrotic syndrome is now sourced and in the body of the article as a risk factor. Biosthmors (talk) 16:38, 20 March 2012 (UTC)

What do to with minor/rare forms/corollaries of DVT?[edit]

Phlegmasia alba dolens and phlegmasia cerulea dolens are currently discussed in the signs and symptoms section. May-Thurner syndrome and Paget-Schrötter disease are just mentioned in the pathophysiology section. And perhaps we're omitting another worthy manifestation. But I'm wondering if we should discuss all these four entities together, perhaps in the classification section. I'm thinking phlegmasia might be too infrequently mentioned/experienced to justify the word count it is currently given in the signs and symptoms section, although it does give characteristic signs. Biosthmors (talk) 17:43, 5 May 2012 (UTC)

I removed reference to alba per this discussion. Biosthmors (talk) 21:01, 4 September 2012 (UTC)

GA Review[edit]

GA toolbox
Reviewing
This review is transcluded from Talk:Deep vein thrombosis/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Cwmhiraeth (talk · contribs) 09:48, 6 June 2012 (UTC) I have taken on the GA review of this article. On first inspection it looks impressive and I will be studying it in much greater detail shortly. Cwmhiraeth (talk) 09:48, 6 June 2012 (UTC)

First thought[edit]

"Deep vein thrombosis" is a noun phrase so the abbreviation DVT should be used grammatically in the same way as the phrase. This means that such a sentence as "... most of those suspected of DVT do not have it after evaluation" is unsatisfactory. If you used "blood clot" instead of DVT in the sentence you would get "... most of those suspected of blood clot do not have it after evaluation." So I would prefer "... most of those suspected of having a DVT do not have it after evaluation". This point is rather fundamental to the article. Maybe DVT is widely used in the way you have used it and I am being pedantic. I would welcome some input from others on this point. Cwmhiraeth (talk) 10:25, 6 June 2012 (UTC)

I would agree but am no expert on grammar and usually count on others to fix mine :-) Doc James (talk · contribs · email) 20:56, 6 June 2012 (UTC)
I'm not sure but this may help. Here's some text from Lijfering et al.: "many people have several of these risk factors but never develop thrombosis; others suffer from thrombosis but have none." I was thinking one could substitute DVT in for thrombosis without creating an issue. It appears the term venous thrombosis is used: "... carriers have a 5-7 fold increased risk of venous thrombosis". Biosthmors (talk) 21:40, 6 June 2012 (UTC)
Here's some text from a free source[3] (page 19S under 5.2): "In pregnant patients with suspected DVT in whom initial proximal CUS is negative..." I'll tweak the example to follow this. Biosthmors (talk) 21:54, 6 June 2012 (UTC)
I thought this might be a problem throughout the article, but it was not. Cwmhiraeth (talk) 14:06, 7 June 2012 (UTC)

First read through[edit]

I have read through the article carefully. In general the prose, grammar, spelling etc. are fine. Here are the small number of points that struck me when considering criterion 1a. I shall consider the other criteria later. There is no rush - I understand that Biosthmors is away for the time being and the review can continue on his return. Cwmhiraeth (talk) 14:06, 7 June 2012 (UTC)

Classification

  1. Bilateral DVT refers to its presence in both legs while unilateral specifies one leg. - What does "it" refer to?

Causes

  1. Venous thrombi are recognized to be caused mainly by a combination of venous stasis and hypercoagulability—but to a lesser extent endothelial damage and activation. The three factors of stasis, hypercoaguability, and alterations in the blood vessel wall represent Virchow's triad, and changes to the vessel wall are the least understood. - The second of these sentences seems largely to repeat the information in the first. Rephrase.
  2. Acquired risk factors include older age, which is the strongest risk factor; after aging, blood composition favors clotting. - Rephrase this.
  3. Relative risks estimates for the three go up to ten or twenty. - Ten or twenty what?

Pathophysiology

  1. In contrast to the understanding for how arterial thromboses occur, as with heart attacks, - Should be understanding "of" but whole sentence is awkward.
  2. As a whole, platelets constitute less of venous thrombi when compared to arterial ones - Awkward.
  3. ... by tissue factor effected thrombin production, which leads to fibrin deposition. - I think this should be "affected".

Surgery patients

  1. ... is estimated to be about four percent. - Why not 4% as in the previous paragraph?

Pregnancy

  1. Homozygous carriers of factor V Leiden or prothrombin G20210A with a family history of VTE were recommended to ... - Recommended by whom?

Prognosis

  1. After the one to two year period after the initial development of symptoms of DVT ... - This sentence is awkward. Could you also explain what "post-thrombotic syndrome" is.

History

  1. Although, the historicity of the medical literature is somewhat questioned as the interpretations of Virchow's work differ. - Awkward.

Status?[edit]

No one seems to have made any comments here for about two weeks. Do you need help? WhatamIdoing (talk) 20:26, 23 June 2012 (UTC)

The nominator was due to be away from home for some time but should be back now. I will remind him about this review. Cwmhiraeth (talk) 05:27, 24 June 2012 (UTC)
I think I've addressed, clarified or reworded the text in relation to all raised concerns. In regards to 1a concerns below, I've made sure each paragraph with recommendations clarify that they were generated by the ACCP.[4] Biosthmors (talk) 23:52, 25 June 2012 (UTC)
Rate Attribute Review Comment
1. Well written:
1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct. The chief problem that I see is the repeated use of the words "suggested" and "recommended" without an indication of who is making these suggestions/recommendations. I suspect that this is referring to the position in the US and the ACCP guidelines but this should be clarified as other organisations, in other parts of the world, may provide different guidance.
1b. it complies with the manual of style guidelines for lead sections, layout, words to watch, fiction, and list incorporation. No problem here.
2. Verifiable with no original research:
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline. Article is well referenced.
2b. all inline citations are from reliable sources, including those for direct quotations, statistics, published opinion, counter-intuitive or controversial statements that are challenged or likely to be challenged, and contentious material relating to living persons—science-based articles should follow the scientific citation guidelines. Article is well referenced.
2c. it contains no original research. As far as I can tell.
3. Broad in its coverage:
3a. it addresses the main aspects of the topic. Topic is comprehensively covered.
3b. it stays focused on the topic without going into unnecessary detail (see summary style).
4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.
5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute. This does not seem to be a problem.
6. Illustrated, if possible, by media such as images, video, or audio:
6a. media are tagged with their copyright statuses, and valid fair use rationales are provided for non-free content. All images are appropriately licensed.
6b. media are relevant to the topic, and have suitable captions. Images and captions are appropriate and helpful.
7. Overall assessment. A good, well-written article that fulfils the GA criteria. Cwmhiraeth (talk) 05:47, 26 June 2012 (UTC)

Internal inconsistency[edit]

I would like to suggest some modifications.

1. On the one hand: "Only pregnant women with strong risk factors for VTE are suggested to receive targeted (INR of 2.0 to 3.0) preventative measures." But on the other, by the end of the paragraph: "Warfarin, a common VKA, is known to have teratogenic effects on the fetus if administered in early pregnancy[55][56] and is not advised in pregnant women."

I think the problem is the tail end of the second sentence. It is generally true that warfarin is contraindicated (to varying degrees traditionally) throughout pregnancy. However, after week 13 (if that can be determined with reasonable assurance) it is a relative issue (in distinction to the high level contraindication earlier, especially between weeks 4 and 12 traditionally, acknowledging that we now substitute with e.g. LMWH prior to conception when possible), but warfarin may still (optionally) be used (with care) in e.g. high-risk mechanical valve situations etc.

2. On a second minor point, "Only pregnant women with strong risk factors for VTE are suggested to receive targeted (INR of 2.0 to 3.0) preventative measures." would be better phrased as "Only pregnant women with strong risk factors for VTE should receive preventative measures such as warfarin therapy with a target INR of 2.0 to 3.0." The present wording is unduly inexact.

3. Lastly, for several reasons a citation for this corrected sentence would be a reasonable expectation. FeatherPluma (talk) 03:40, 29 July 2012 (UTC)

Thanks for the feedback. I think the sourcing for the warfarin sentence is probably the weakest in the entire article, so I will work on this tomorrow. If you have any other ideas you can mention them here or at Wikipedia:Peer review/Deep vein thrombosis/archive2, which is currently open. Biosthmors (talk) 15:57, 29 July 2012 (UTC)
The current statement is false and potentially harmful. The reference describes the use of warfarin in the postpartum period, not in pregnant women. Warfarin is teratogenic during the first trimester, and can cause dangerous antepartum haemorrhage during the third trimester. Therefore warfarin is contra-indicated during pregnancy. Axl ¤ [Talk] 17:55, 29 July 2012 (UTC)
Glad you caught that. This fixes the error, right? Biosthmors (talk) 21:13, 30 July 2012 (UTC)
Recent secondary sources are now cited and I think things are corrected. Biosthmors (talk) 21:57, 30 July 2012 (UTC)
Yes, thank you. Axl ¤ [Talk] 22:46, 30 July 2012 (UTC)

Smoking?[edit]

I find it interesting that the article does not list smoking as a causal factor. It seems to be the conventional wisdom that smoking increases the risk of DVT, but the only medical studies I've been able to find online (which are quite old, dating from the late 1970s) concluded that smoking had a PROTECTIVE effect against the formation of DVTs. It would be nice if knowledgeable medical professionals could supplement the article with peer-reviewed evidence about the effects of smoking. I emphasize 'peer-reviewed,' because most websites that list smoking as a causal factor do not cite any evidence in support of the statement. They make logical conclusions about the harmful effects of vasoconstriction and platelet aggregation, but do not validate the conclusions through empirical testing. — Preceding unsigned comment added by 202.130.114.242 (talk) 09:34, 10 August 2012 (UTC)

Smoking as a risk factor is cited by some while some cite it as not well established. The mechanism is elusive. I'm not sure whether or not to cite it. "Smoking is a risk factor for VTE, although the effect is much less for arterial thrombosis and the evidence less consistent.16 There are no mechanistic studies on the relationship between VTE and smoking, but it may be safe to postulate an inflammatory state of the endothelim, also involving components of innate immunity." says doi:10.1161/ATVBAHA.111.242818. The 2008 study they cite is here. Lijfering cites this study and puts it into their table under "Not well established" with a confidence interval of 0.8 to 1.5. van Langevelde says the confidence interval is 1.3 to 1.7 for a risk of DVT in smokers after citing the same 2008 study. Biosthmors (talk) 22:11, 10 August 2012 (UTC)
doi:10.1055/s-0031-1297367 has a nice section devoted to this topic. Biosthmors (talk) 19:13, 5 September 2012 (UTC)

Primary study on aspirin after unprovoked VTE[edit]

doi:10.1056/NEJMoa1114238 is the study and doi:10.1016/j.beha.2012.06.003 might be an appropriate secondary source. Biosthmors (talk) 05:24, 25 August 2012 (UTC)

Recent review article[edit]

This might be useful:

  • de Jong PG, Coppens M, Middeldorp S (2012). "Duration of anticoagulant therapy for venous thromboembolism: balancing benefits and harms on the long term". British Journal of Haematology. 158 (4): 433–41. doi:10.1111/j.1365-2141.2012.09196.x. PMID 22734929. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

It says under Risk of recurrence after unprovoked VTE, that men have a higher risk of recurrent VTE than women, and it's gives generally good coverage of the other risk factors. Graham Colm (talk) 14:43, 10 September 2012 (UTC)

Thanks for pointing this article out. Biosthmors (talk) 21:27, 10 September 2012 (UTC)
Please be careful not to conflate VTE with DVT. Axl ¤ [Talk] 22:51, 10 September 2012 (UTC)
Surely, thanks. Biosthmors (talk) 17:22, 11 September 2012 (UTC)

Removing some sources[edit]

I don't understand the value behind this edit because the version before already said that, and now (after removing the sources that appear to have no value) it appears the source that is left understates what is unnecessary, which appears to contradict the article. So I'm going to remove it. Biosthmors (talk) 02:49, 27 September 2012 (UTC)

Comprehensiveness[edit]

  • For comprehensiveness, the epidemiology section should include a paragraph on provoked DVT, and provoked DVT should probably be defined in classification. Biosthmors (talk) 19:52, 25 October 2012 (UTC)
  • Duration of anticoagulation in those with cancer could be mentioned, as could more detail on preventative treatments after surgeries. Biosthmors (talk) 19:53, 25 October 2012 (UTC)
  • Guideline for chronic cases. Biosthmors (talk) 19:23, 14 November 2012 (UTC)

Consistency[edit]

Thrombus or thrombosis? Biosthmors (talk) 04:19, 6 November 2012 (UTC)

Imo, both: thrombosis for the condition, thrombus / thrombi for the actual clot/s. —MistyMorn (talk) 08:50, 7 November 2012 (UTC)
Hmmmm... OK thanks I'll look at this further. Biosthmors (talk) 19:53, 7 November 2012 (UTC)
Etymologically: thrombosis, clot formation; thrombus, the clot formed. At least, that's according to Wikipedia... [5] [6] ;) —MistyMorn (talk) 20:42, 7 November 2012 (UTC)


High probability or high-probability? Biosthmors (talk) 22:19, 10 November 2012 (UTC)

You mean "A Wells score can be divided into two (likely vs. unlikely) or three (low, moderate, or high probability) groups"? If so,looking good as is. More generally, to hyphen or not to hyphen in adjectival phrases that qualify a noun, like "high-throughput PCR", depends on house style. Wikipedia seems to like them [7], BMJ doesn't [8], and some, like Malleus, have, on occasion, been known to get hot-under-the-collar (ouch, no!) hot under the collar. —MistyMorn (talk) 22:55, 10 November 2012 (UTC)
Thanks I'll remove. Biosthmors (talk) 23:19, 10 November 2012 (UTC)
Hmmm.... "at-risk", "bed-rest", "oxygen-deprived"... I need to find a rule to draw the line and make things consistent... Biosthmors (talk) 23:34, 10 November 2012 (UTC)
Looks like Malleus might handle that for you. :) —MistyMorn (talk) 00:33, 11 November 2012 (UTC)
I'm a hyphen black belt, no worries on that score. As a general rule Biosthmors you only need need hyphens with compound adjectives, to avoid ambiguity. For example, "Wayne Rooney is a well-known footballer", as opposed to "Wayne Rooney is well known". Malleus Fatuorum 03:57, 11 November 2012 (UTC)
Excellent (Rooney apart)! Presumably where the convention originally came from. —MistyMorn (talk) 10:32, 11 November 2012 (UTC)
Thanks Malleus for your help. I wonder if "at-risk long-haul travelers" should be "at-risk-long-haul travelers". This document helped clarify most issues. Biosthmors (talk) 21:02, 14 November 2012 (UTC)

Clarification query[edit]

In the United States (U.S.) population, about 5 to 8% of people have thrombophilia of some form.<ref name="CDC"/> Among people who develop VTE, 30 to 50% have thrombophilia. Prevalence estimates are as follows: 0.5 to 9% for antithrombin deficiency, 3 to 9% for protein C deficiency, 1 to 3% for protein S deficiency, 12 to 20% for heterozygous factor V Leiden, 6 to 8% for heterozygous prothrombin G20210A, 0.2 to 4% for the homozygous case, and 2 to 4.5% for individuals doubly heterozygous for factor V Leiden and prothrombin G20210A.<ref name="Varga"/>

Prevalence among whom? Among people who develop VTE in the U.S.? (Sorry, I don't have access to the paper.) —MistyMorn (talk) 00:51, 7 November 2012 (UTC)

I'll replace the U.S. centric reference with Varga completely to generalize, thanks. Biosthmors (talk) 02:08, 7 November 2012 (UTC)
Great. —MistyMorn (talk) 08:36, 7 November 2012 (UTC)

Upper extremity deep vein thrombosis[edit]

UEDVT should perhaps be split off into its own article. Biosthmors (talk) 19:51, 7 November 2012 (UTC)

Wells score[edit]

A section of the 2012 NICE guideline, Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing: worth citing here (and, perhaps, elsewhere)? Also, Righini et al, 2006 may be helpful, although as a primary study it doesn't technically meet WP:MEDRS. —MistyMorn (talk) 09:46, 12 November 2012 (UTC)

Thanks for the tip. I plan to work that guideline in to avoid systemic bias per JFW's comments here. Biosthmors (talk) 16:34, 12 November 2012 (UTC)
Thanks, I'd missed that. Fwiw, I also feel there are more acronyms/abbreviations than necessary. Although they generally seem to be standard ones which could normally be included in a review article, I feel a more conservative approach is preferable on Wikipedia (though I don't see much on the subject in WP:MEDMOS). —MistyMorn (talk) 20:08, 12 November 2012 (UTC)
Thanks again. There's another comment like that in the peer review, so I'll plan on moving that way with GCS, IPC, and PTS. Currently, I think VTE is repeated enough/central enough to keep. Biosthmors (talk) 20:20, 12 November 2012 (UTC)
FYI, I'm leaning towards keeping VKA and LMWH. Biosthmors (talk) 19:03, 15 November 2012 (UTC)

History[edit]

Someone has written a history of DVT. Citeable: doi:10.1111/jth.12127 JFW | T@lk 21:38, 15 January 2013 (UTC)

Great, thanks! Biosthmors (talk) 22:14, 15 January 2013 (UTC)
The article has yet to be incorporated into the article's history section but I do plan on doing so. Biosthmors (talk) 18:23, 18 December 2019 (UTC)

Comments[edit]

The imaging images might be better presented horizontally in that section with one of these: Template:Multiple_image#See_also. Biosthmors (talk) 22:25, 3 March 2013 (UTC)

Done. Biosthmors (talk) 17:20, 4 April 2013 (UTC)

Epidemiology of provoked DVT might be a topic to include. Biosthmors (talk) 01:58, 12 March 2013 (UTC)

Inherited risk factors and DVT[edit]

All the recent reviews I remember seeing only list genetically determined blood states as inherited risk factors. So I don't think listing May–Thurner syndrome/Cockett syndrome/Iliac vein compression syndrome is best as was done with this edit. This source, on page 15S, says "Knowledge of the underlying cause of iliac vein compression syndrome...", which to me suggests we shouldn't assume it's a purely genetic/inherited trait. Biosthmors (talk) 17:17, 4 April 2013 (UTC)

Post-thrombotic syndrome and thrombophilia[edit]

doi:10.1111/jth.12447 - the hypothesis that thrombophilia leads to an increased risk of post-thrombotic syndrome can be rejected. Systematic review & meta-analysis. JFW | T@lk 13:26, 13 November 2013 (UTC)

Treatment review[edit]

doi:10.1001/jama.2014.65 JAMA JFW | T@lk 11:06, 20 February 2014 (UTC)

Developments[edit]

Mainly about NOACs - Br J Haem doi:10.1111/bjh.13431 JFW | T@lk 12:03, 23 April 2015 (UTC)

Laterality[edit]

http://www.nejm.org/doi/full/10.1056/NEJMcp1407434 mentions laterality in pregnancy at the beginning of the article, which seems worthy of a mention, at least in a footnote. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 12:18, 16 September 2015 (UTC)

Compression stockings[edit]

... are not much good doi:10.1016/j.amjmed.2015.11.031 JFW | T@lk 11:59, 11 March 2016 (UTC)

I believe that the article reflects this knowledge now. Biosthmors (talk) 17:52, 2 January 2020 (UTC)

Lancet seminar[edit]

doi:10.1016/S0140-6736(16)30514-1 JFW | T@lk 08:25, 2 September 2016 (UTC)

Merge[edit]

Have removed the merge tag. For one venous thrombosis includes a wide variety of conditions (DVT, PE, cerebral venous thrombosis, etc). DVT is one specific type of venous thrombosis. Doc James (talk · contribs · email) 05:55, 31 December 2016 (UTC)

Prevention[edit]

Prevention/research directions looks like it could use updating perhaps. doi:10.1056/NEJMoa1700518 Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 13:11, 4 April 2017 (UTC)

In general, http://journal.publications.chestnet.org/SS/Antithrombotic_Guideline.aspx could be used to update the article. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 22:01, 21 June 2017 (UTC) (dead link)

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Assignment feedback[edit]

As part of a student assignment, feedback on DVT was posted on a user's talk page: [9]. I believe I have already addressed their concerns with regard to compression stockings, but I'll double check. Biosthmors (talk) 17:13, 30 December 2019 (UTC)

Deep bone thrombosis[edit]

I think that "deep bone thrombosis" (dbt) is the same thing as deep vein thrombosis. I'm not sure, but here is some corroborating text: 

About 297 results (0.27 seconds) 
Search Results
Featured snippet from the web
Deep bone thrombosis, which is clotting in the veins that can cause a range of leg pain – this can become a life threatening illness if not addressed.
...
Other symptoms of PAD include:

    numbness/tingling in the lower legs and feet.
    coldness in the lower legs and feet.
    ulcers or sores on the legs or feet that do not heal.

Leg Pain
https://www.viralegs.com › leg-pain

Web results
Causes of Deep Bone Thrombosis - Graphic Online
https://www.graphic.com.gh › Ghana news Headlines › Health
May 2, 2014 - Dear mirror doctor I am a very active 46-year-old man who drives to and from work with no problems. I noticed a gradual increase in the size of ...

Assessment 2 (1) | Thrombosis | Vein - Scribd
https://www.scribd.com › document › Assessment-2-1
Nov 20, 2017 - Deep vein thrombosis deep bone thrombosis (DVT) is a blood clot thrombosis in a major vein that usually develops in the legs and/or pelvis. 2.

Deep Vein Thrombosis - Its a real issue if you drive too much ...
https://uberpeople.net › Geographical › Australia › Sydney
Feb 21, 2016 - 20 posts - ‎18 authors
... abuse prescription drugs and are actually obese telling us all we have to live healthier. On the Deep bone Thrombosis thing just make sure if ...

Leg Pain
https://www.viralegs.com › leg-pain
Deep bone thrombosis, which is clotting in the veins that can cause a range of leg pain – this can become a life threatening illness if not addressed.

Myumaimah : http://myumaimah.com/
https://myumaimah.com.cutestat.com
... wear compression stockings, compression socks for sale, deep bone thrombosis, varicose vein clinic, jobst compression socks, vertical veins in legs, where to ...

The House That Hugh Laurie Built: An Unauthorized Biography ...
https://books.google.com › books
Paul Challen - 2010 - ‎Biography & Autobiography
Within a minute in their first diagnostic session, House has ruled out the schizophrenia as a cause of the deep bone thrombosis (dbt). Unlike his other patients, ...

Deep Bone Thrombosis is Sexy | Torn Flesh Records
https://tornfleshrecords.bandcamp.com › track › deep-bone-thrombosis-is-...
Deep Bone Thrombosis is Sexy by Torn Flesh Records, released 18 November 2013.

Cafe on the Edge of Outer Space - Page 1 - Google Books Result
https://books.google.com › books
Robert Appleton - 2008 - ‎Interstellar travel
It's a deep-bone thrombosis of stars and gravitational attraction. Body to body, orbit to orbit, me to her. We're cosmic trespassers, and I feel just as transparent as ...

The Complete Testament - Page 1011 - Google Books Result
https://books.google.com › books
BLA BLA BLA, WE COULD NOT STOP GIVING HIM HIS MEDICATION EVEN HE IS SHOWING SIGNS OF DEEP BONE THROMBOSIS, BUT BECAUSE WE ...

Dr. Sunder Narasimhan - General Surgeon - Book ... - Practo
https://www.practo.com › bangalore › doctor › sunder-narasimhan-vascula...
Rating: 88% - ‎154 votes - ‎Price range: ₹700 consultation fee
Filter placement for deep bone thrombosis. ○. Cerucial rib. ○. Thoracic Outlet Syndrome. ○. Arterial Duroubosis. ○. Arterial Occlusion. ○. Mesentric Ischemia.

From https://www.google.com/search?client=firefox-b-1-d&q=%22Deep+bone+thrombosis%22 --User123o987name (talk) 16:21, 31 December 2019 (UTC)

It seems to be a misunderstanding/misspelling by people who really mean deep venous thrombosis. Tellingly, there are only 216 Google hits on your search. Most of the hits are not written by healthcare professionals. I did not find the phrase at all in PubMed. Axl ¤ [Talk] 12:18, 2 January 2020 (UTC)

Cite heart failure as a DVT risk factor? Bigger question: is it OK to cite VTE risk factors as DVT risk factors?[edit]

Greetings User:Graham Beards. After a long hiatus, I am back to working on this article, which you previously reviewed. Thank you. Because of your comment towards the bottom of Wikipedia:Peer review/Deep vein thrombosis/archive3, I did recently incorporate mention of stroke [10] and I have been researching the potential impact of heart failure. Regarding heart failure as a risk factor for DVT, I am not yet sure. My current opinion is limited by general internet access. A 2016 systematic review and meta-analysis (doi:10.1016/S2352-3026(15)00228-8), for example, states in the abstract "Many studies have investigated the association between venous thromboembolism and heart failure, but have yielded inconsistent findings" but then concludes "Heart failure is a common independent risk factor for venous thromboembolism". Yet it seems odd to cite this article to support the claim that heart failure is a risk factor for DVT because this study is limited to hospitalized patients, and hospitalization itself is already cited on the article as a DVT risk factor. Also, it could be the case that statistical significance for VTE is demonstrated by pooling DVT and PE data while the statistical significance for DVT might not yet be independently established. Similarly, I saw a 2019 study [11] where heart failure appears more correlated with isolated PE than DVT with or without PE, called DVT/PE in this study. While the 2016 meta-analysis suggested that their findings could be considered in future prophylaxis regimens, for what it's worth, the most recent 2018 clinical practice guidelines [12] (that the CDC prominently features on their website[13]) don't have any separate guidance on heart failure patients. I feel a bit lost in the weeds here, but at this point it doesn't seem like a firm fact to call heart failure a risk factor for DVT (unless we operate under the assumption that VTE risk factors are always DVT risk factors). So, should VTE risk factors be cited on the DVT article as DVT risk factors? Biosthmors (talk) 17:07, 2 January 2020 (UTC)

Perhaps we should just specify that the risk factors in this article are VTE risk factors and then that fixes this issue. Biosthmors (talk) 17:36, 2 January 2020 (UTC)

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