Why DVT Navigator?
Guideline-Grounded Provocation & Surveillance Stratification
Seamlessly integrates CHEST 2021, ASH, and AHA/ACC guidelines to distinguish proximal DVT from isolated distal calf thrombi. Automates serial compressive ultrasound surveillance protocols versus immediate therapeutic anticoagulation, preventing unnecessary medication exposure.
Precision DOAC Dosing & Organ Safety Gatekeeper
Calculates Cockcroft-Gault creatinine clearance (CrCl) alongside renal cutoffs, hepatic impairment markers, and body weight extremes (BMI ≥ 40 kg/m² or weight > 120 kg) to deliver tailored, first-line DOAC selection and lead-in dosing recommendations.
Client-Side Privacy & Instant EHR Documentation
Operates entirely client-side with zero protected health information (PHI) stored or transmitted over external networks. Automatically synthesizes full clinical encounters into structured, plain-text documentation ready for one-click copy-paste into Epic, Cerner, or outpatient EHRs.
Clinical Workflow: 5-Stage Guideline Architecture
Stage 1: Anatomical Confirmation & Cardiopulmonary Screening
- Anatomical Localization: Classifies thrombus site (iliofemoral, femoral, popliteal, isolated distal calf) and laterality.
- PE Safety Checkpoint: Screens for acute cardiopulmonary compromise (dyspnea, pleuritic pain, hypoxia, tachycardia) requiring immediate pulmonary embolism workup.
- Provocation Stratification: Differentiates major transient, minor transient, persistent risk factors, and unprovoked presentations to project 1-year and 5-year recurrence rates.
Stage 2: Organ Function, Bleeding Risk & Safety Gatekeepers
- Renal & Hepatic Parameters: Incorporates baseline CrCl and Child-Pugh classification to detect absolute and relative contraindications.
- Bleeding Risk Scoring: Evaluates active bleeding, thrombocytopenia, prior intracranial hemorrhage, severe hypertension, and concomitant antiplatelet/NSAID therapy.
- Special Populations: Provides safety screening for pregnancy, lactation, active malignancy, and extreme weight variations.
Stage 3: Regimen Selection & Lead-In Dosing Protocols
- First-Line Selection: Evaluates preferred direct oral anticoagulants (Apixaban, Rivaroxaban, Dabigatran, Edoxaban) versus low-molecular-weight heparin (LMWH) and Warfarin.
- Loading Dose Guidance: Clearly distinguishes regimens requiring upfront parenteral bridging (Dabigatran, Edoxaban) from oral single-drug loading protocols (Apixaban 10 mg BID × 7 days, Rivaroxaban 15 mg BID × 21 days).
- Drug-Drug Interaction Safeguards: Flags combined P-glycoprotein and strong CYP3A4 inhibitors/inducers.
Stage 4: Treatment Duration & Extended Secondary Prevention
- Finite vs. Extended Anticoagulation: Establishes definitive 3-month finite courses for provoked transient DVT versus extended secondary prevention for unprovoked or persistent risk cohorts.
- Dose De-escalation: Evaluates criteria for reduced-dose secondary prevention regimens (Apixaban 2.5 mg BID or Rivaroxaban 10 mg daily) after completion of initial therapeutic phases.
- Surveillance Protocols: Outlines weekly duplex ultrasound monitoring windows for low-risk isolated distal calf DVT managed without initial anticoagulation.
Stage 5: Longitudinal Monitoring & EHR Synthesis
- Monitoring Schedule: Establishes scheduled check-in intervals (2–4 weeks, 3 months, annually) for renal re-evaluation, adherence assessment, and bleeding checks.
- EHR Export: Generates formatted clinical notes summarizing diagnostic scenario, provocation etiology, regimen rationale, and follow-up timeline for direct chart integration.
How to Use the DVT Navigator in Practice
- Input Diagnostic Confirmation & Thrombus Location: Record duplex ultrasound confirmation, clot anatomical level (proximal vs. calf), symptom severity, and confirm the absence of acute cardiopulmonary PE symptoms.
- Classify Provoking Risk Factors: Select all applicable surgical, trauma, hormonal, travel, or medical risk factors to categorize the event as provoked (major/minor transient), persistent, or unprovoked.
- Run Safety Screening & Organ Function: Utilize the integrated Cockcroft-Gault calculator to determine CrCl and input relevant bleeding risks, organ dysfunction, and co-medications.
- Select Regimen & Review Evidence Callouts: Review personalized, guideline-directed anticoagulant options, verifying necessary lead-in loading doses or serial ultrasound surveillance recommendations.
- Copy Formatted Summary to EHR: Finalize treatment duration, generate the structured clinical progress note in Step 5, and click the copy button to paste the documentation directly into your clinical charting system.
