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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Simon Noble, Cardiff University, United Kingdom
- Second opponent: Associate Professor Tone Dahl-Michelsen, OsloMet - Oslo Metropolitan University, Norway
- Third member and chair of the evaluation committee: Professor II Jonny Hisdal, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor II Anne Flem Jacobsen, University of Oslo
Principal Supervisor
Consultant in haematology Hilde Skuterud Wik, Department of Haematology, Oslo University Hospital
Summary
Approximately 50% of patients with proximal deep venous thrombosis (DVT) will develop chronic leg problems recognized as post-thrombotic syndrome (PTS). There is no curative treatment, and PTS is associated with increased health care costs and reduced quality of life. There is no objective test for diagnosing PTS. In clinical practice, patients with typical lower limb symptoms minimum 3-6 months after a DVT, and with no other obvious cause, are considered to have PTS. Because of the lack of a gold standard diagnostic test, various criteria have been used, limiting the possibility to compare results across studies and implement study findings in clinical practice. Since 2009, to standardize the definition of PTS, the Villalta scale has been recommended in trials despite acknowledged limitations in its diagnostic accuracy.
The overall objective of the present study was to evaluate the diagnostic accuracy of the Villalta scale with PTS diagnosed in line with clinical practice as reference. We aimed to identify core symptoms and clinical presentations that might form the basis of a more accurate diagnostic tool for future PTS assessment. Finally, we examined possible predictors of PTS during long-term follow-up of a proximal DVT population.
Patients and clinical experts were included in a qualitative study exploring typical PTS complaints through four group interviews. In the following quantitative cross-sectional study, we included patients with a history of proximal DVT during 2006-09 and evaluated the diagnostic accuracy of the Villalta scale by comparing the scale with four predefined clinical criteria.
By examining the diagnostic accuracy of the Villalta scale through a combination of methodologies, our findings indicate that the diagnostic accuracy of the scale has limitations and does not seem to capture several typical PTS complaints or reflect adequately on the impact of the PTS symptoms and signs.
Additional information
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