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Review: the Wells clinical prediction guide and D-dimer testing predict deep vein thrombosis

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 Q Does a clinical prediction guide (CPG) with or without D-dimer testing predict deep vein thrombosis (DVT)?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Haematology ★★★★★★☆


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Medline (1990 to 1 July 2004) and relevant references in English and French.

Embedded ImageStudy selection and assessment

studies were selected if they were prospective trials with ⩾3 month follow up, enrolled consecutive outpatients with symptoms and signs suggestive of DVT, used a validated CPG to estimate the clinical probability (low, moderate, and high) of DVT before D-dimer testing or diagnostic imaging, and evaluated proximal DVT. In studies that included D-dimer testing, testing had to be done before other diagnostic tests. Studies of patients with previous DVT that was not adjusted for by the CPG or the reviewers were excluded. 14 studies (n = 8239) met the selection criteria; …

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  • For correspondence: Dr P S Wells, University of Ottawa, Ottawa, Ontario, Canada. pwells{at}

  • Sources of funding: Canada Research Chairs Program; Hamilton Health Sciences; Haematology Societies of Australasia and New Zealand and Australia.