What question did this study set out to answer?

To review the diagnostic accuracy, clinical utility, and limitations of various D-dimer assays in safely ruling out acute venous thromboembolism in symptomatic patients.

January 1, 1999Thrombosis and Haemostasis

D-Dimer Testing in the Diagnosis of Acute Venous Thromboembolism

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Implication

Clinical review demonstrates high negative predictive value of D-dimer in low-risk outpatients, suggesting safe exclusion of thromboembolism without advanced imaging.

Key Points

To review the diagnostic accuracy, clinical utility, and limitations of various D-dimer assays in safely ruling out acute venous thromboembolism in symptomatic patients.
Synthesized findings from accuracy and management studies evaluating conventional ELISA, rapid ELISA, and whole-blood agglutination assays (SimpliRED) for suspected DVT and PE.
Assessed diagnostic performance when combining D-dimer testing with standardized pretest probability clinical models and noninvasive imaging modalities.
In suspected deep vein thrombosis, a normal D-dimer achieved a negative predictive value of 99.5% in patients with low pretest likelihood versus 85.7% in those with high pretest likelihood.
In suspected pulmonary embolism, combining a normal D-dimer with low pretest probability yielded a negative predictive value of 99%, compared to 78% in high-probability patients.
Assay performance varied substantially across manufacturers, demonstrating that high sensitivity is required to reliably eliminate the need for serial ultrasounds or lung perfusion scans.

Cite This Study

A 1999 study studied this question.

synapsesocial.com/papers/6a7d76e3c66da78fab8b397b https://doi.org/10.1055/s-0037-1615898

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Implication

Clinical review demonstrates high negative predictive value of D-dimer in low-risk outpatients, suggesting safe exclusion of thromboembolism without advanced imaging.

D-Dimer Testing in the Diagnosis of Acute Venous Thromboembolism

Discussion

Member takes

Implication

Key Points

Cite This Study

D-Dimer Testing in the Diagnosis of Acute Venous Thromboembolism

Discussion

Member takes

Implication

Key Points

Cite This Study

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