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Hopkins GIM Faculty Contribute to New ACP Guidelines on VTE

The American College of Physicians (ACP) released new clinical practice guidelines last week for the diagnosis and management of venous thromboembolism (VTE). Two Hopkins GIM faculty members, Drs. Jodi Segal and Eric Bass are among the authors. Developed in cooperation with the American Academy of Family Physicians (AAFP), the guidelines were posted on the Annals of Internal Medicine Web site and will be published, along with an evidence guide, in the Feb. 6 print issue of Annals.

Each guideline contains several recommendations to aid in the diagnosis and treatment of lower extremity deep venous thrombosis and pulmonary embolism. Key elements of the diagnosis guideline include the use of clinical prediction rules to establish pretest probability of deep vein thrombosis or pulmonary embolism in a patient before further testing and the utility of various diagnostic tools such as D-dimer and ultrasonography.

The management guideline supports the use of low-molecular-weight heparin for patients with deep vein thrombosis in the outpatient setting when appropriate support services are in place.

The new diagnosis guideline targets primary care physicians who are most likely to have frontline contact with patients who have not yet been diagnosed. Incidence rates for VTE are higher in men and African-Americans, and increase substantially with age. Treating VTE at an early stage can avoid complications such as pulmonary embolism or recurrent DVT.

The full guidelines are available here.