ruling out deep vein thrombosis in patients with superficial vein thrombosis: external validation of the icaro score

A clinical score was recently proposed to rule out concomitant dvt in patients with a clinical suspicion of svt. this study aimed to assess the external validity of this score in patients from the steph study. we performed a post-hoc analysis of data from the steph study. the steph study was a prospective multicenter community-based study conducted during a 1-year period in the resident adult population of the greater saint-etienne urban area (france). every patient with a clinical suspicion of svt underwent a venous compression ultrasonography, to confirm svt and to assess the presence of a concomitant dvt or not. odds ratios for concomitant dvt were calculated for each item of the icaro score. we then computed the score for each patient, and performed a receiver operating characteristic (roc) curve analysis. in univariate analysis, none of the icaro items were significantly different given the presence of a concomitant dvt. given computed scores, 55 patients (45.1%) had a low risk, 17 (13.9%) had an intermediate risk and 50 (41.0%) had a high risk of a concomitant dvt. the area under the roc curve was 0.386 [95% ci, 0.268–0.504]. when risk levels were dichotomized as low vs intermediate-high risk, the icaro score had a sensitivity of 36.0%, a specificity of 40.2%, a positive predictive value of 13.4% and a negative predictive value of 70.9%. our study does not confirm the utility of the icaro clinical score to rule out concomitant dvt in case of svt.