D-dimer testing and acute venous thromboembolism. A shortcut to accurate diagnosis?
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.
Becker
D M
DM
Department of Medicine, University of Virginia School of Medicine, Charlottesville, USA.
Philbrick
J T
JT
Bachhuber
T L
TL
Humphries
J E
JE
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*
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D