Investigating Discrepancies Between Pre-Vascular Clinic and Vascular Clinic Venous Doppler Studies in Patients with Chronic Venous Insufficiency: A Single-Center Study

Venous Doppler ultrasound is a critical diagnostic tool used to evaluate venous conditions such as chronic venous insufficiency (CVI). Many patients who are referred to the vascular clinic come in with prior venous Dopplers, and later have another venous Doppler done as part of the vascular clinic visit. However, disparities in Doppler findings may occur due to variations in technique, equipment, examiner experience, or patient factors between external Dopplers and those performed in a vascular clinic. These disparities can cause inefficiencies in patient care and impact clinical management and patient outcomes. This study aims to investigate the presence and extent of discrepancies between pre-vascular clinic and vascular clinic Doppler studies, identify contributing factors, and evaluate the clinical implications of these differences. A prospective cohort analysis will be conducted on patients who had both pre-vascular clinic and vascular clinic Doppler studies. Data on patient demographics, clinical characteristics, and Doppler parameters (e.g., peak systolic velocity, reflux time, and anteroposterior diameter for key venous segments) will be analyzed. Statistical methods will include paired comparisons, logistic regression, and subgroup analysis to identify factors associated with Doppler discrepancies and assess their clinical impact. The study will highlight key sources of variability between pre-vascular clinic and vascular clinic venous Doppler studies,  and allow us to propose solutions to facilitate greater diagnostic accuracy.

 Research Question/Hypothesis:

The purpose of this study is to determine the extent of disparity between pre-vascular clinic visit venous Doppler and vascular clinic visit venous Doppler. We hypothesize that there is a significant discrepancy between pre-vascular clinic and vascular clinic venous Doppler findings in terms of assessment of superficial venous reflux which can cause inefficiency in patient care and influence clinical decision-making and patient outcomes. Patient comorbidities, type of facility, and interpreting professional’s experience are hypothesized to be significant predictors of these discrepancies.

 Primary:

• Determine if there is a discrepancy between Pre-vascular visit Venous Doppler and Vascular Venous Doppler Studies in Patients with Chronic Venous Insufficiency based on venous Doppler parameters and clinical outcomes

Secondary:

• Identify variables associated with discrepancies

• Assess change in clinical management

• Identify association between discrepancies and specific Doppler measurements