title: [The unresolved issue of false-positive D-dimer results in the diagnostic workup of pulmonary embolism].
abstract: The unresolved issue of false-positive D-dimer results in the diagnostic workup of pulmonary embolism Pulmonary embolism (PE) remains a difficult diagnosis as it lacks specific symptoms and clinical signs. After the determination of the pretest PE probability by a validated clinical score, D-dimers (DD) is the initial blood test in the majority of patients whose probability is low or intermediate. The low specificity of DD results in a high number of false-positives that then require thoracic angio-CT. A new clinical decision rule, called the Pulmonary Embolism Rule-out criteria (PERC), identifies patients at such low risk that PE can be safely ruled-out without a DD test. Its safety has been confirmed in US emergency departments, but retrospective European studies showed that it would lead to 5-7% of undiagnosed PE. Alternative strategies are needed to reduce the proportion of false-positive DD results.
authors.affiliation: Service des urgences, CHUV, 1011 Lausanne. olivier.hugli@chuv.ch
authors.forename: O
authors.initials: O
authors.lastname: Hugli
authors.forename: D
authors.initials: D
authors.lastname: Aujesky
mesh_terms: D000465:Algorithms; D000933:Antifibrinolytic Agents / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: D000933:Antifibrinolytic Agents; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D