Key result
A negative d-dimer value safely excluded deep venous thrombosis in outpatients with a moderate pretest probability (NPV 100%, 95% CI 85-100).
Why the study?
Does a diagnostic protocol including clinical evaluation and d-dimer testing safely exclude deep venous thrombosis in outpatients with a moderate pretest probability?
Observational (n=134)
Does a diagnostic protocol including clinical evaluation and d-dimer testing safely exclude deep venous thrombosis in outpatients with a moderate pretest probability?
Effect estimate: NPV 100% (95% CI 85-100)
A negative d-dimer test safely excludes deep venous thrombosis in outpatients with a moderate pretest probability, similar to its utility in low-risk patients.
May support d-dimer exclusion in moderate-probability outpatients; extends low-risk data but leaves open prospective validation.
The negative predictive value (NPV) of d-dimer (DD) for the exclusion of venous thromboembolism is, overall, high and tends to increase as clinical pretest probability decreases. We have assessed the accuracy of a diagnostic protocol including clinical evaluation and DD in 134 outpatients presenting with a moderate pretest probability of proximal deep venous thrombosis (DVT). In these patients, a negative DD value safely excluded DVT (NPV 100%, 95% CI 85-100) In our experience, these results are equivalent to those found for low-pretest probability patients and therefore the same diagnostic strategy can be used for both risk groups.
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Aguilar et al. (2002) conducted an observational in Deep venous thrombosis (n=134). d-dimer testing was evaluated on Exclusion of DVT (Negative Predictive Value) (NPV 100%, 95% CI 85-100). A negative d-dimer value safely excluded deep venous thrombosis in outpatients with a moderate pretest probability (NPV 100%, 95% CI 85-100).
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