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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?
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.
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 were extracted independently by 2 reviewers on study quality, patient characteristics, the diagnostic standard, and the sensitivity and specificity of the test.
11 studies involving 2126 patients met the selection criteria. The prevalence …