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Related Experiment Video

Updated: May 28, 2026

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

Cost associated with D-Dimer screening for acute aortic dissection.

Theodoros Moysidis¹, Marc Lohmann, Sarah Lutkewitz

¹Department of Angiology, Helios Klinikum Krefeld, Krefeld, Germany.

Advances in Therapy

|October 20, 2011

Summary

This summary is machine-generated.

D-Dimer (DD) testing for acute thoracic aortic dissection (TAD) in chest pain patients did not improve diagnosis or cost-effectiveness. Clinical judgment remains crucial for diagnosing TAD and other conditions.

Related Experiment Videos

Last Updated: May 28, 2026

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

Area of Science:

Emergency Medicine
Cardiovascular Diagnostics
Clinical Pathology

Background:

D-Dimer (DD) is a known predictor of thoracic aortic dissection (TAD) and associated mortality.
This study investigated the utility of DD screening for acute TAD in patients presenting with chest pain.
The research also explored the association of DD levels with other common diagnoses in emergency department patients.

Purpose of the Study:

To evaluate if D-Dimer (DD) screening improves the diagnosis of acute thoracic aortic dissection (TAD) in chest pain patients.
To assess the cost-effectiveness of using DD screening compared to routine computerized tomography (CT) scans for TAD.
To determine the association of DD levels with other common diagnoses presenting as dyspnea or chest pain.

Main Methods:

Analysis of 1053 patients admitted for chest pain to a nonsurgical emergency department.
DD testing was performed on 102 patients presenting with chest pain.
Diagnostic reliability was assessed using sensitivity, specificity, and odds ratios.

Main Results:

No cases of acute TAD were identified among the study participants.
Restricting CT scans to patients with elevated DD levels would have significantly reduced costs compared to universal CT use.
DD testing showed low sensitivity and specificity for diagnosing other conditions, except for pneumonia.

Conclusions:

DD screening for acute TAD in this low-incidence population increased diagnostic efforts and costs without clear diagnostic speed benefits.
DD testing was not effective in discriminating other relevant diagnoses in the clinical setting.
Physician's clinical judgment remains the most important factor in diagnosing TAD, despite literature suggesting high DD sensitivity.