D-dimer useful for excluding deep vein thrombosis and pulmonary embolism
The Journal of Family Practice. 2004 September;53(9):682-690
September 1, 2004|The Journal of Family Practice
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- CLINICAL QUESTION: Can the D-dimer test be used to rule out suspected thromboembolism?
- STUDY DESIGN: Meta-analysis (other)
- SETTING: Various (meta-analysis)
- SYNOPSIS: To answer the question about the role of D-dimer testing in patients with suspected deep vein thrombosis (DVT) or pulmonary embolism (PE), the authors of this meta-analysis identified 78 high-quality studies by searching Medline and EMBASE for evaluative studies in all languages. They also performed a secondary analysis using 30 more studies with weaker study designs. As is now standard in meta-analyses, 2 authors determined what studies would be included and 2 authors independently extracted the data and then compared their results.
BOTTOM LINE
Although diagnostic tests often are good for both identifying and excluding disease, sometimes tests do one better than the other. A normal D-dimer test result can be relied upon to rule out suspected pulmonary embolism or deep vein thrombosis. It is not particularly helpful, by itself, to rule in the diagnosis. The results of this meta-analysis confirm an earlier meta-analysis (Ann Emerg Med 2002; 40:133–144). (LOE=1a)
