Appropriateness of Duplex ultrasound assessment on venous system of the legs: a two-month preliminary analysis

AIM: The goal of this study is to evaluate the appropriateness to prescribe venous ultrasound of lower limbs. MATERIAL OF STUDY: Over a two months period, 1005 Duplex scans were performed by our Vascular Surgery Unit; out of the total, 225 exams were conducted on venous system of lower limbs. We retrospectively analyzed appropriateness of prescription (according to Lombardy District indications), urgency of prescription, time-lapse between application for the exams and its execution, positive or negative results, National Health System's sustained cost. RESULTS: During the above mentioned period, 87,5% of the exams were conducted as normal screening with no urgency characteristics, 61 exams (27%) were combined with arterial duplex of the same district. General Practitioners' requests accounted for 76,8% while only 9,7% were from vascular surgeons. Following indications of appropriateness, 117 exams (52%) were judged as appropriate. Combining appropriateness and result (x(2) test) we found that if the indication was inappropriate the negative result rate was 90,75%; in the group of exams prescribed with an urgent request the rate of appropriateness raised to 60,7% of whose 94.1% were pathologically positive. DISCUSSION: There is no evidence in Literature about appropriateness of prescription of Duplex ultrasound for vascular districts. While Lombardy District recently published guidelines for prescription, neither vascular surgeon societies nor National Health Service ever provided any indication. CONCLUSION: Nowadays there is increasing demand for appropriateness in healthcare. This study delivered such significant data to make it a pivotal study for an extended analysis during 2016.