Table 6.

Strength of Evidence for Major Recommendations

Strength of Recommendation*
Diagnostic recommendations
    Relative frequencies of causes of edema in Tables 131,4,53C
    Clinical findings that help distinguish venous edema, lymphedema, and lipidema8,9,11,12,21,22,24C
    Important components of the patient history9–12,24,54C
    Important components of physical exam2,9–12,22,24C
    Echocardiogram recommended in patients over age 454C
    Medications that cause edema4,13,14,16,17,24,55C
    Normal D-dimer rules out deep vein thrombosis25,56B
    Use of Doppler exam to confirm or rule out deep vein thrombosis57–59B
Treatment recommendations
    Diuretics to treat venous insufficiency2C
    Horse chestnut seed extract to treat venous insufficiency41–44B
    Compression stockings to treat venous insufficiency60C
    Diuretics to treat idiopathic edema5,31,46C
  • * Strength of recommendation classified according to the 3-component SORT system61: A, denotes recommendation based on consistent and good-quality patient-oriented evidence61; B, denotes recommendation based on inconsistent or limited-quality patient-oriented evidence61; C, denotes recommendation based on consensus, usual practice, opinion, disease-oriented evidence, or case series for studies of diagnosis, treatment, prevention, or screening.61