We thank Dr Reynolds1 for carefully reading and commenting on our article,2 and indeed must agree that the maximum score on the Oudega rule is 13 points (as a patient cannot be both male and taking oral contraceptives). We do stress, however, that from a GP's point of view, the most valuable use of the Oudega rule is to exclude deep venous thrombosis (DVT). For that purpose, a threshold at three points or fewer (please note, this automatically includes a negative D-dimer test) is safe for excluding DVT in primary care. Using a point-of-care D-dimer test, it is even possible to safely exclude DVT during the consultation of the patient. Hence, with the use of the Oudega rule and a point-of-care D-dimer test, DVT management has now definitely entered the realm of primary care.
- © British Journal of General Practice, 2011
