Embargoed Jan./Feb. Annals of Family Medicine...( nd treatment of venous thromboembolism...),Health

nd treatment of venous thromboembolism, a condition that is associated with over 200,000 deaths each year in the United States. A thromboembolism occurs when a blood clot, formed at one point in the circulatory system, detaches and obstructs circulation at another point. A pulmonary embolism occurs when such a clot, usually originating in the deep venous system of the lower extremities, obstructs the pulmonary artery or one of its branches, which may result in acute heart failure or sudden death. These recommendations are a collaborative effort of the American Academy of Family Physicians and the American College of Physicians.

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, utility of various diagnostic tools such as d-dimmer 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. Each guideline contains several recommendations based on current evidence to clinicians to aid in the diagnosis and treatment of lower extremity deep venous thrombosis and pulmonary embolism.

The Annals of Family Medicine and the Annals of Internal Medicine have joined together in publishing the new guidelines. Both guidelines and an evidence review for the diagnosis guideline are published in this issue of Annals of Family Medicine. The management guideline and companion evidence review are published in the February 6, 2007, issue of Annals of Internal Medicine. Annals of Internal Medicine will publish the diagnosis guideline online at www.annals.org on the same day it is published in the Annals of Family Medicine.

Current Diagnosis of Venous Thromboembolism in Primary Care: A Clinical Practice Guideline from the
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Contact: Kristin Robinson
kristinr@aafp.org
913-906-6000, ext. 5221
American Academy of Family Physicians
29-Jan-2007

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