Management of suspected lower-extremity deep venous thrombosis.

In the course of developing a new technique for medical decision making, we used the data from an article that appeared in theArchives 1 as the basis for a decision model. Our results did not agree with the published results 1 for several of the management strategies. For example, our software (and decision trees drawn by hand) indicated that the expected cost of strategy A ("No tests or treatment") was $1905, not $2220 as published. Our decision-tree representation of strategy A ( Figure 1 ) and one that explains the study 1 results ( Figure 2 ) are enclosed. The mortality and cost of several other strategies differ from our calculations as well. In fact, our analysis, which evaluated a superset of the 24 strategies evaluated by Hillner et al 1 showed that, with the article's "standard model" assumptions, the most cost-effective management strategy is not strategy I ("If real-time ultrasonography [RUS] suggests deep