This article is more than 5 years old. Information may no longer be current.
Meta-analysis: D-dimer excluded VTE in outpatients
Click Here to Manage Email Alerts
Point-of-care D-dimer testing — both qualitative and quantitative — safely ruled out venous thromboembolism in low-risk outpatients, according to data from a meta-analysis. The researchers added that quantitative tests performed better than qualitative tests, although point-of-care D-dimer added information and guided patient management in those suspected of deep vein thrombosis.
The researchers used Medline and Embase to identify results of studies published between January 1995 and September 2008 that indicated the accuracy of point-of-care D-dimer. The analysis included 23 studies’ results. In these studies, researchers compared D-dimer with reference criteria for VTE, enrolled consecutive outpatients and allowed for construction of a 2 × 2 table.
Two qualitative point-of-care D-dimer tests — SimpliRED D-dimer and Clearview Simplify D-dimer — and two quantitative point-of-care D-dimer tests — Cardiac D-dimer and Triage D-dimer — were reported in the studies. The researchers estimated sensitivity and specificity, and examined reasons for variation using bivariate regression.
Overall sensitivity ranged from 0.85 (95% CI, 0.78-0.90) to 0.96 (95% CI, 0.91-0.98) and overall specificity ranged from 0.48 (95% CI, 0.33-0.62) to 0.74 (95% CI, 0.69-0.78). Cardiac D-dimer and Triage D-dimer were most favorable, according to the researchers.
“Both qualitative and quantitative point-of-care D-dimer tests can safely exclude VTE in low-risk outpatients,” they wrote.
Geersing GJ. BMJ. 2009;doi:10.1136/bmj.b2990.