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Q In patients with suspected deep venous thrombosis (DVT), is a combination of rapid D-dimer testing with estimation of clinical probability accurate for excluding a diagnosis of DVT?
Clinical impact ratings IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Emergency Medicine ★★★★★☆☆ Haematology ★★★★★☆☆
METHODS
Data sources:
Medline (1993–2003), Database of Abstracts and Reviews, and bibliographies of relevant articles.
Study selection and assessment:
prospective studies (published in English) that used a rapid D-dimer assay on at least a subgroup of consecutive outpatients with features of DVT; estimated the risk of DVT using a validated clinical probability tool that categorised patients as having low, intermediate, or high risk of 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 …
Footnotes
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For correspondence: Dr T L Fancher, Division of General Medicine, University of California at Davis, Sacramento, California, USA. Tonya. Fancherucdmc.ucdavis.edu
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Source of funding: US Health Resources and Services Administration’s Faculty Development in Primary Care.