VENOUS THROMBOEMBOLISM:FREQUENCY/MANAGEMENT/COST-SAVINGS

在过去的20年里，我们在理解 静脉血栓栓塞的问题。 诱发因素较好 据了解，有效的预防方法是可用的，可靠的 已经开发出诊断测试，并有效治疗深度 静脉血栓形成（DVT）。 最近这些新的影响 进步应该是大大降低静脉血栓形成的发病率和死亡率， 血栓栓塞，导致显着的成本节约;然而，肺 栓塞（PE）仍然导致估计10万至20万人死亡， 年 几乎没有数据记录目前的做法模式， DVT/PE的管理，目前尚不清楚为什么这么多患者 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 估计有750名医生在17个国家执业 大都会伍斯特医院在他们的诊断和治疗深 静脉血栓和肺栓塞。 这些数据将用于 找出当前临床实践模式中存在的问题。 一个教育 然后将以随机对照设计的形式进行项目， 纠正发现的缺陷。 这项教育计划对 随后将审查选定的临床结果和节省的费用。 这些结果将提供客观数据，以记录目前的做法， 建立具体的教育干预措施在提高 DVT/PE的处理。

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.