VENOUS THROMBOEMBOLISM:FREQUENCY/MANAGEMENT/COST-SAVINGS

在过去的20年里，在理解 静脉血栓形成的问题。易感因素较好 理解，有效的预防方法是可用的，可靠的 已经开发出诊断测试，并有效地治疗深部 静脉血栓形成(DVT)是可用的。最近这些事件的新影响 进步应该是大大降低静脉感染的发病率和死亡率。 血栓栓塞症，导致显著的成本节约；然而，肺 据估计，栓塞症(PE)每年仍导致10万至20万人死亡 年。记录当前实践模式的数据很少 DVT/PE的管理，目前尚不清楚为什么有这么多患者 继续死于一种基本上可以预防的疾病。 拟议的调查将试图通过一个 对临床因素、管理标准和 17年估计有750名医生使用的治疗方法 大都会伍斯特医院在深部诊断和治疗中的作用 静脉血栓形成和肺栓塞。这些数据将用于 找出当前临床实践模式中的问题。一个有教育意义的 计划将以随机对照设计的形式进行 纠正已识别的缺陷。这个教育项目对 随后将对选定的临床结果和成本节约进行检查。 这些结果将提供客观数据，以记录当前的做法和 确定特定教育干预措施在改善教育方面的价值 DVT/PE的管理。

Over the last 20 years, important advances have been made in understanding the problem of venous thromboembolism. Predisposing factors are better understood, effective methods of prophylaxis are available, reliable diagnostic tests have been developed, and effective treatment for deep venous thrombosis (DVT) is available. The new effect of these recent advances should be to greatly decrease morbitity and mortality from venous thromboembolism, resulting in significant cost-savings; however, pulmonary embolism (PE) still causes an estimated 100,000 to 200,00 deaths each year. Little data exist documenting the current patterns of practice in the management of DVT/PE, and it remains unclear why so many patients continue to die from a largely preventable disease. The proposed investigation will attempt to answer this question through a community-wide study of the clinical factors, management criteria, and approaches used by an estimated 750 physicians practicing in 17 Metropolitan Worcester hospitals in their diagnosis and treatment of deep venous thrombosis and pulmonary embolism. These data will be used to identify problems in current patterns of clinical practice. An educational program will then be conducted in a randomized controlled design format to correct identified deficiencies. The effect of this educational program on selected clinical outcomes and cost-savings will be subsequently examined. These results will provide objective data to document current practices and to establish the value of specific educational interventions in improving the management of DVT/PE.