title: D-dimer testing and acute venous thromboembolism. A shortcut to accurate diagnosis?
abstract: D-dimer fragments can be measured easily in plasma and whole blood, and the presence or absence of D-dimer could be useful in the diagnostic evaluation of venous thromboembolism. We systematically reviewed the English literature for articles that compared D-dimer results with those of other tests for deep venous thrombosis or pulmonary embolism. Twenty-nine studies were selected for detailed review, and we noted wide variability in assay performance, heterogeneity among subjects, and failure to define absence or presence of venous thromboembolism by a comprehensive criterion standard for diagnosis. These methodologic problems limit the generalizability of the published estimates of D-dimer accuracy for deep venous thrombosis or pulmonary embolism, and the clinical utility of this potentially important test remains unproved.
authors.affiliation: Department of Medicine, University of Virginia School of Medicine, Charlottesville, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Becker
authors.forename: J T
authors.initials: JT
authors.lastname: Philbrick
authors.forename: T L
authors.initials: TL
authors.lastname: Bachhuber
authors.forename: J E
authors.initials: JE
authors.lastname: Humphries
mesh_terms: D000208:Acute Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007163:Immunosorbent Techniques; D007841:Latex Fixation Tests; D011655:Pulmonary Embolism / Q000175:diagnosis*; D013924:Thrombophlebitis / Q000175:diagnosis*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D