Related Experiment Video
Updated: Jun 3, 2026
10:26
A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
Improving D-dimer Positive Predictive Value for Outpatients with Suspected Deep Vein Thrombosis
The Permanente Journal
|March 5, 2011
Summary
A new Trinity Biotech D-dimer assay significantly improved specificity and positive predictive value for diagnosing deep vein thrombosis (DVT). This advancement reduces unnecessary compression ultrasounds (CUS) and enhances diagnostic accuracy.
Area of Science:
- Medical Diagnostics
- Hematology
- Clinical Pathology
Background:
- Sensitive D-dimer assays are crucial for excluding deep vein thrombosis (DVT) when used with diagnostic algorithms.
- Improving D-dimer assay specificity enhances the utility of compression ultrasound (CUS).
Purpose of the Study:
- To evaluate a new D-dimer assay's ability to improve specificity and positive predictive ability compared to a previously used assay.
- Assess the impact on Bayesian probability for DVT diagnosis.
Main Methods:
- Retrospective review of 1015 patients with suspected DVT.
- Comparison of bioMérieux D-dimer test system (503 patients) with Trinity Biotech D-dimer test system (512 patients).
- Statistical assessment of sensitivity, specificity, positive predictive value, and Bayesian probabilities.
Main Results:
- Trinity Biotech assay increased specificity from 41.3% to 66.9%.
- Positive predictive value increased 2.3-fold (8.8% to 20.0%) with the Trinity Biotech assay.
- Reduced false positives and unnecessary CUSs, improving DVT diagnosis probability.
Conclusions:
- The Trinity Biotech D-dimer assay demonstrates superior clinical performance over the bioMérieux assay.
- This new assay significantly enhances diagnostic accuracy and efficiency in suspected DVT cases.
- Implementation of the Trinity Biotech assay can lead to fewer unnecessary CUS procedures.
Related Concept Videos
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:27Pulmonary Embolism III: Nursing Management
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
01:30Venous Thrombosis I: Introduction
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...