Does clinical probability estimation combined with D-dimer testing accurately exclude deep vein thrombosis?
Patients being evaluated for deep vein thrombosis (DVT)
Clinical probability estimation using a predictive rule combined with D-dimer testing
Diagnostic accuracy for deep vein thrombosis
In patients with a low clinical probability of DVT, a negative D-dimer test safely excludes the diagnosis without requiring an ultrasound.
Diagnostic accuracy for DVT improves when clinical probability is estimated before diagnostic tests. Patients with low clinical probability on the predictive rule have prevalence of DVT of less than 5%. In low-probability patients with negative D-dimer results, diagnosis of DVT can be excluded without ultrasound; in patients with high clinical suspicion for DVT, results should not affect clinical decisions.
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Philip S. Wells
JAMA
University of Ottawa
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Philip S. Wells (Tue,) studied this question.
www.synapsesocial.com/papers/69d690e496200ba434db82df — DOI: https://doi.org/10.1001/jama.295.2.199
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