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Review: ELISA D-dimer is sensitive but not specific in diagnosing pulmonary embolism in an ambulatory clinical setting

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 QUESTION: What is the accuracy of the enzyme linked immunosorbent assay (ELISA) D-dimer test in diagnosing pulmonary embolism (PE) in the emergency department or outpatient clinic?

Data sources

Studies were identified by searching Medline (January 1980 to 1 January 2001), EMBASE/Excerpta Medica, and the bibliographies of previous systematic reviews and identified studies; and by contacting experts in the field and the manufacturers of ELISA D-dimer.

Study selection

Studies were selected if they prospectively investigated the use of ELISA D-dimer tests in patients with suspected PE who presented to an emergency department or outpatient clinic. Reviews and editorials were excluded.

Data extraction

Data were extracted independently by 2 reviewers on study quality, patient characteristics, the diagnostic standard, and the sensitivity and specificity of the test.

Main results

11 studies involving 2126 patients met the selection criteria. The prevalence …

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  • Source of funding: no external funding.

  • For correspondence: Dr M D Brown, Spectrum Health-Butterworth, Grand Rapids, Michigan, USA. brownm{at}

  • Abstract and commentary also published in ACP Journal Club