title: A comparison of three rapid D-dimer methods for the diagnosis of venous thromboembolism.
abstract: We compared three rapid D-dimer methods for the diagnosis of venous thromboembolism. Patients presenting to four teaching hospitals with the possible diagnosis of deep vein thrombosis or pulmonary embolism were investigated with a combination of clinical likelihood, D-dimer (SimpliRED) and initial non-invasive testing. Patients were assigned as being positive or negative for deep vein thrombosis or pulmonary embolism based on their three-month outcome and initial test results. The three D-dimer methods compared were: (a) Accuclot D-dimer (b) IL-Test D-dimer (c) SimpliRED D-dimer. Of 993 patients, 141 had objectively confirmed deep vein thrombosis or pulmonary embolism. The sensitivity of SimpliRED, Accuclot and IL-Test were 79, 90 and 87% respectively. All three D-dimer tests gave similar negative predictive values. The SimpliRED D-dimer was found to be less sensitive than the Accuclot or IL-Test. When combined with pre-test probability all three methods are probably acceptable for use in the diagnosis of venous thromboembolism.
authors.affiliation: Department of Medicine, London Health Sciences Centre, London, Ontario, Canada. michael.kovacs@lhsc.on.ca
authors.forename: M J
authors.initials: MJ
authors.lastname: Kovacs
authors.forename: K M
authors.initials: KM
authors.lastname: MacKinnon
authors.forename: D
authors.initials: D
authors.lastname: Anderson
authors.forename: K
authors.initials: K
authors.lastname: O'Rourke
authors.forename: M
authors.initials: M
authors.lastname: Keeney
authors.forename: C
authors.initials: C
authors.lastname: Kearon
authors.forename: J
authors.initials: J
authors.lastname: Ginsberg
authors.forename: P S
authors.initials: PS
authors.lastname: Wells
mesh_terms: D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D011237:Predictive Value of Tests; D011336:Probability; D011655:Pulmonary Embolism / Q000175:diagnosis; D011933:Reagent Kits, Diagnostic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020246:Venous Thrombosis / Q000175:diagnosis*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D011933:Reagent Kits, Diagnostic; C036309:fibrin fragment D