Key result
Relying on D-dimer testing in isolation to exclude venous thromboembolism should be avoided, as normal D-dimer levels can occur despite thrombosis due to delayed presentation or prior anticoagulation.
Clinical evaluation and probability scoring should precede D-dimer testing to exclude venous thromboembolism, as normal D-dimer levels can occur in VTE due to delayed presentation, prior anticoagulation, or assay variability.
The shift to primary care expected in the initial ‘diagnostic’ management of cases of venous thromboembolism is indeed welcome. A recent article in the BJGP highlighted the role of D-dimer in reducing referrals for radiological imaging.1 However, one of the messages that needs to be stressed in this context is the importance of clinical probability scoring system. It is important that the primary care physicians do not over-rely on …
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Jecko Thachil (2012) conducted a letter in Venous thromboembolism. D-dimer testing in isolation vs. Clinical probability scoring system and assessment was evaluated. Relying on D-dimer testing in isolation to exclude venous thromboembolism should be avoided, as normal D-dimer levels can occur despite thrombosis due to delayed presentation or prior anticoagulation.
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