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Related Experiment Videos

D-dimer testing for deep venous thrombosis: a metaanalysis.

Steven W Heim1, Joel M Schectman, Mir S Siadaty

  • 1Department of Family Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA. heims@virginia.edu

Clinical Chemistry
|May 15, 2004
PubMed
Summary
This summary is machine-generated.

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D-dimer assays for deep venous thrombosis (DVT) show variable performance. Their use as a standalone rule-out test is not supported due to inconsistent sensitivity and negative predictive values.

Area of Science:

  • Medical Diagnostics
  • Hematology
  • Vascular Medicine

Background:

  • Deep venous thrombosis (DVT) diagnosis often relies on D-dimer testing, but its efficacy as a rule-out test remains debated.
  • Variability in D-dimer assay performance necessitates a comprehensive review to assess their diagnostic utility.

Purpose of the Study:

  • To systematically review the literature on D-dimer assay performance for diagnosing deep venous thrombosis (DVT).
  • To evaluate the accuracy and reliability of various D-dimer assays in symptomatic patients suspected of acute DVT.

Main Methods:

  • A systematic literature search was conducted using MEDLINE and bibliographies from February 1995 to October 2003.
  • Level 1 studies, identified through rigorous quality appraisal, compared D-dimer tests against lower extremity ultrasound or venography in suspected DVT patients.

Related Experiment Videos

Main Results:

  • Twenty-three Level 1 studies evaluated 21 different D-dimer assays, revealing significant variations in sensitivity, specificity, and negative predictive values.
  • Multivariate analysis indicated that higher DVT prevalence correlated with poorer test performance, while venography as a reference standard improved performance.
  • Assay performance varied widely due to differences in assay characteristics, patient group heterogeneity, and reference standard bias.

Conclusions:

  • The wide variability in D-dimer assay performance, with frequently suboptimal sensitivity and negative predictive values, challenges their role as a reliable rule-out test for DVT.
  • The current literature does not support the general use of D-dimer assays as a standalone diagnostic tool for deep venous thrombosis.