We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
An evaluation of rapidD-dimer assays for the exclusion of deep vein thrombosis.
- Authors
Gardiner, Chris; Pennaneac'h, Coralie; Walford, Claire; Machin, Samuel J; Mackie, Ian J
- Abstract
We evaluated the performance of eightd-assays for the exclusion of deep vein thrombosis (DVT); Biopool AutoDimer, Biopool MiniQuant, bioMèrieux MDAd-Dimer, VIDAS, Dade Behringd-Dimer Plus, Trinity Biotech AMAX, NycoCardd-dimer and IL Testd-Dimer. The assays were evaluated both as stand-alone tests, and in combination with pretest probability (PTP).d-dimer assays and PTP assessment were performed on 410 patients presenting to the emergency department with suspected acute DVT. DVT was diagnosed in 76 of 410 patients (18·5%) by compression ultrasound or other imaging techniques, as required. Receiver operator characteristics analysis established optimum cut-off values and these were compared with manufacturer's cut-off values where provided. As stand-alone tests, the assays varied immensely regarding cut-off value, negative predictive value (NPV 93–100%) and specificity (0–67%). At least one patient with confirmed DVT had a lowd-dimer level by each method: to achieve 100% sensitivity it would be necessary to reduce cut-off values to levels below clinical usefulness. When lowd-dimer was used in combination with PTP, six of eight methods achieved≥98% NPV, with a diagnosis of DVT excluded in 16–44% of patients without the requirement for diagnostic imaging. The highly variable diagnostic performance of thesed-dimer assays means that some assays are unsuitable for certain diagnostic strategies. However, our data suggest that the combination of sensitived-dimer assays with an assessment of PTP may be used to exclude a diagnosis of DVT.
- Subjects
THROMBOSIS; BLOOD vessels; DIMERS; MEDICAL imaging systems; HOSPITAL emergency services; DIAGNOSTIC imaging
- Publication
British Journal of Haematology, 2005, Vol 128, Issue 6, p842
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/j.1365-2141.2005.05394.x