Improved access to noninvasive investigation and a declining tolerance for diagnostic uncertainty has resulted in increasing numbers of patients who are referred with suspected venous thromboembolism (VTE), all of whom require objective testing to confirm or exclude the diagnosis. Hence, the proportion of patients with suspected VTE in whom the diagnosis is confirmed has fallen progressively from 30 to 35% in the 1970s and 1980s,1–3
to around 15 to 25% in the last decade.4–6
Indeed, prevalences of < 10% have been reported.7
This trend is not inappropriate for a potentially fatal disorder that can be effectively treated, but it has important resource implications.