Diagnostic et traitement des varices des membres inférieurs - KCE

14 Varicose Veins KCE Reports 164
3 RESULTS: DIAGNOSTIC PROCEDURES FOR
VARICOSE VEINS
3.1 IDENTIFIED STUDIES AND QUALITY APPRAISAL
3.1.1 Selection of two diagnostic studies
The literature search for relevant diagnostic RCTs was carried out in January 2011
identifying 933 citations. The majority of citations were excluded on the basis of title
and abstract, mainly because the population or interventions were without the scope of
this study. The other papers (n=18) were retrieved in full and reviewed in detail. Due to
the low number of relevant trials an additional database search of Medline and EMBASE
was carried out in May 2011 with a search strategy designed to capture observational
studies. This search yielded 921 citations but no new relevant studies were identified
from this search. The reference lists of all relevant articles and reviews were scanned to
identify any further relevant studies.
On the basis of the full text, seven of the 18 studies were excluded :
• two evaluated clinical examination as the index test40 41;
• four had outcomes not relevant to diagnosis such as cost data or prevalence
of reflux at different anatomical sites42-45;
• one studied incompetent perforating veins, a patient group out of the scope
of this review46.
Nine other studies on hand-held doppler were further excluded upon the advice of
experts and validators. This technique has not been in use in many years: in 2006 an
international consensus agreed upon the role of duplex ultrasound for the preoperative
assessment of varicose veins 26 . The quality and results of these nine studies
can be found in appendix 9.2.4 and 9.2.5.
Therefore, two studies were finally included and assessed for their methodological
quality.
Figure 1 shows the results of the literature searches and flow of studies.