What does this research mean for the field?

Plasma D-dimer measurement using ELISA accurately rules out deep venous thrombosis with a 100% negative predictive value at levels below 200 micrograms/L, whereas latex D-dimer tests lack sufficient sensitivity for emergency screening. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 1989

Measurement of Plasma D-Dimer for Diagnosis of Deep Venous Thrombosis

Structured PICO

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

Intervention

Plasma D-dimer measurement using two latex tests and an enzyme-linked immunosorbent assay (ELISA)

Comparator

Total fibrin(ogen) degradation products (FDPs) in serum (with venography as the reference standard)

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.

Abstract

Venography was performed on fifty-six patients suspected of having deep venous thrombosis (DVT) of the legs. The accuracy of the D-dimer measurement in plasma using two latex tests and an enzyme-linked immunosorbent assay (ELISA) was compared with that of usual determination of total fibrin(ogen) degradation products (FDPs) in serum with respect to the presence of DVT. The three D-dimer tests were clearly superior to the FDP assay, but only the ELISA could accurately rule out the diagnosis of DVT with a predictive value of 100% when plasma D-dimer level was less than 200 micrograms/L. However, this test cannot be used for positive diagnosis (false positive rate of 69%). Thus, plasma D-dimer measurement with ELISA allows identification of patients in whom further investigation by means of more specific tests (venography or plethysmography) is indicated in order to establish the diagnosis of DVT. In contrast to this, sensitivity of the two latex tests studied was low (60 and 76%, respectively), which makes them unsuitable for emergency screening. In addition, the potential of D-dimer dosage for diagnosis of DVT in hospitalized patients is hampered by the presence of associated conditions that are responsible for elevated plasma levels in most cases.

Ask AI

Helpful

Bookmark