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Assessment (screening or diagnosis)
Review: a low clinical probability plus a normal d-dimer test result excludes a diagnosis of deep venous thrombosis

https://doi.org/10.1136/ebn.8.2.58

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    Fancher TL, White RH, Kravitz RL. Combined use of rapid d-dimer testing and estimation of clinical probability in the diagnosis of deep vein thrombosis: systematic review. BMJ 2004;329:821.OpenUrlAbstract/FREE Full Text

    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?

    METHODS

    Embedded ImageData sources:

    Medline (1993–2003), Cochrane Database of Abstracts and Reviews, and bibliographies of relevant articles.

    Embedded ImageStudy 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; …

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    Footnotes

    • For correspondence: Dr T L Fancher, Division of General Medicine, University of California at Davis, Sacramento, CA, USA. Tonya.Fancherucdmc.ucdavis.edu

    • Source of funding: US Health Resources and Services Administration’s Faculty Development in Primary Care.