Review: a low clinical probability plus a normal d-dimer test result excludes a diagnosis of deep venous thrombosis
Q In patients with suspected deep venous thrombosis (DVT), is a combination of rapid d-dimer testing and estimation of clinical probability accurate for excluding a diagnosis of DVT?
Medline (1993–2003), Cochrane Database of Abstracts and Reviews, and bibliographies of relevant articles.
Study selection and assessment:
prospective studies (published in English) of consecutive outpatients with features of DVT that used a rapid d-dimer assay on at least a subgroup of patients; estimated the risk of DVT using a validated clinical probability tool that categorised patients as having low, intermediate, or high risk for DVT; evaluated outpatient data separately if inpatients were included; evaluated DVT data separately if patients with pulmonary embolism were included; had 100% patient follow up at ⩾3 months; documented DVT using ultrasonography, venography, or impedance plethsmography; and presented sufficient data for calculation of sensitivity and specificity of the d-dimer assay and prevalence …