The Efficiency of Hamilton Pretest Probability Value in Diagnosing Deep Vein Thrombosis

Deep vein thrombosis (DVT) is a condition, in which an obstruction of blood flow in veins is found due to the formation of blood clots in the deep veins. An objective diagnosis of DVT is based on ultrasonography examination. However, in poor countries, including Indonesia, many hospitals still do not have the facilities of ultrasonography, less vascular specialists, or D-dimer examination and therefore, to establish the diagnosis of DVT they only can rely on history taking and physical examination. To find out whether the high Hamilton PPS can be used to diagnosis of DVT and whether the high Hamilton score the greater the possibility for DVT, and to know it sensitivity and specificity. A cross-sectional study was done, which was conducted to identify the reliability (sensitivity and specificity) of Hamilton PPS in establishing DVT diagnosis. The study used the Color Duplex Sonography (CDS) for extremity veins as the gold standard. We enrolled 193 patients with probability of DVT. Hamilton PPS and extremity veins CDS were done and tabulation was performed and data was analyzed statistically. Data analysis for testing was performed by the logistic regression analysis and Receiver Operating Characteristic curve using a computer software program of SPSS version 17.0. Hamilton score has sensitivity 0.8, specificity 0.85, accuracy of value 0.84 and positive predictive value 0.63, negative predictive value 0.93.The correlation between Hamilton score and sonography to diagnosis of DVT is positive with the sensitivity and specificity of Hamilton score is ≥ 80 %.