January 1, 1989American Journal of Clinical Pathology
Measurement of Plasma D-Dimer for Diagnosis of Deep Venous Thrombosis
Why the study?
Does plasma D-dimer measurement accurately diagnose or rule out deep venous thrombosis in suspected patients?
Population
56 patients suspected of having deep venous thrombosis (DVT) of the legs
Comparison
Plasma D-dimer measurement using two latex tests… vs Total fibrin degradation products in serum
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
May rule out DVT with ELISA D-dimer <200 μg/L but positives require confirmation; leaves open prospective validation.
Key Points
- The study aims to compare the accuracy of different D-dimer tests for diagnosing deep venous thrombosis (DVT).
- Fifty-six patients suspected of DVT underwent venography to confirm the diagnosis.
- D-dimer levels were measured using two latex tests and an enzyme-linked immunosorbent assay (ELISA).
- The accuracy of these tests was compared to the traditional total fibrin degradation products (FDP) assay.
- The ELISA test accurately ruled out DVT with a predictive value of 100% at plasma D-dimer levels below 200 micrograms/L.
- False positive rate for the ELISA was 69%, making it unsuitable for positive diagnosis.
- Latex tests showed low sensitivity (60% and 76%), indicating they are ineffective for emergency screening.
Structured PICO
Does plasma D-dimer measurement accurately diagnose or rule out deep venous thrombosis in suspected patients?
P
Population
56 patients suspected of having deep venous thrombosis (DVT) of the legs
I
Intervention
Plasma D-dimer measurement using two latex tests and an enzyme-linked immunosorbent assay (ELISA)
C
Comparator
Total fibrin(ogen) degradation products (FDPs) in serum (with venography as the reference standard)
O
Outcome
Diagnostic accuracy for the presence of DVTsurrogate
ELISA D-dimer testing is highly effective for ruling out DVT when levels are <200 micrograms/L, but its low specificity requires further testing for positive results.
Limitations
- Potential of D-dimer dosage for diagnosis in hospitalized patients is hampered by associated conditions causing elevated levels
Cite This Study
Bounameaux et al. (1989) studied this question.