December 15, 1993JAMA
Quantitative plasma D-dimer levels among patients undergoing pulmonary angiography for suspected pulmonary embolism
Key result
Quantitative plasma D-dimer levels >500 ng/mL demonstrated a sensitivity of 93.3% (95% CI, 81.7%-98.6%) and a negative predictive value of 91.4% for diagnosing acute pulmonary embolism.
Why the study?
Does a quantitative plasma D-dimer level less than 500 ng/mL accurately rule out acute pulmonary embolism in patients undergoing diagnostic pulmonary angiography?
Population
173 patients undergoing diagnostic pulmonary arteriography for suspected acute pulmonary embolism at four…
Comparison
Quantitative plasma D-dimer levels measured… vs Pulmonary angiographic results.
Design
Cross-sectional, Blinded comparison
Authors
Discussion
Loading...
Member takes
Implication
May support avoiding angiography if D-dimer <500 ng/mL; leaves open prospective validation before practice change.
Study Design
Type
Observational (n=173)
Blinding
Blinded
Multicenter
Yes
Structured PICO
Does a quantitative plasma D-dimer level less than 500 ng/mL accurately rule out acute pulmonary embolism in patients undergoing diagnostic pulmonary angiography?
P
Population
173 patients undergoing diagnostic pulmonary angiography for suspected acute pulmonary embolism.
E
Exposure
Quantitative plasma D-dimer levels measured using a monoclonal antibody assay (specifically evaluating a threshold of <500 ng/mL).
C
Comparator
Pulmonary angiographic results (criterion standard test).
O
Outcome
Sensitivity, specificity, and predictive values of quantitative plasma D-dimer levels for the diagnosis of pulmonary embolism.surrogate
Main Result
Effect estimate: Sensitivity 93.3% (95% CI 81.7% to 98.6%)
p-value: p=0.016
Quantitative plasma D-dimer levels less than 500 ng/mL have a high negative predictive value for acute pulmonary embolism, potentially obviating the need for invasive pulmonary angiography.
Cite This Study
Samuel Z. Goldhaber (1993) conducted an observational in Suspected acute pulmonary embolism (n=173). Quantitative plasma D-dimer levels vs. Pulmonary angiography was evaluated on Sensitivity, specificity, and predictive values for the diagnosis of acute pulmonary embolism (Sensitivity 93.3%, 95% CI 81.7% to 98.6%, p=0.016). Quantitative plasma D-dimer levels >500 ng/mL demonstrated a sensitivity of 93.3% (95% CI, 81.7%-98.6%) and a negative predictive value of 91.4% for diagnosing acute pulmonary embolism.