<scp>d</scp>-Dimer and Venous Thromboembolism
Authors: Stephen J. Wolf
Journal: Annals of Internal Medicine (2004)

Letters21 September 2004d-Dimer and Venous ThromboembolismStephen J. Wolf, MDStephen J. Wolf, MDFrom Denver Health Medical Center, Denver, CO 80204.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-6-200409210-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Stein and colleagues' systematic review (1) provides clinicians with a thorough compilation of the data published to date for application of d-dimer in the setting of suspected deep venous thrombosis (DVT) and pulmonary embolism. Unfortunately, I worry that the authors' conclusions may only continue to muddy the waters regarding the utility of the d-dimer assay in this particular setting.The authors imply in their conclusion that radiographic evaluation of patients for suspected pulmonary embolism is not indicated after a negative result on quantitative rapid enzyme-linked immunosorbent assay (ELISA). This is based on the assumption that negative likelihood ...References1. Stein PD, Hull RD, Patel KC, Olson RE, Ghali WA, Brant R, et al . d-Dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med. 2004;140:589-602. [PMID: 15096330] LinkGoogle Scholar2. Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). The PIOPED Investigators. JAMA. 1990;263:2753-9. [PMID: 2332918] CrossrefMedlineGoogle Scholar3. Wells PS, Ginsberg JS, Anderson DR, Kearon C, Gent M, Turpie AG, et al . Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med. 1998;129:997-1005. [PMID: 9867786] LinkGoogle Scholar4. Wells PS, Anderson DR, Rodger M, Ginsberg JS, Kearon C, Gent M, et al . Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 2000;83:416-20. [PMID: 10744147] CrossrefMedlineGoogle Scholar5. Perrier A, Desmarais S, Miron MJ, de Moerloose P, Lepage R, Slosman D, et al . Non-invasive diagnosis of venous thromboembolism in outpatients. Lancet. 1999;353:190-5. [PMID: 9923874] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Denver Health Medical Center, Denver, CO 80204. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of a Clinical Model for Safe Management of Patients with Suspected Pulmonary Embolism Philip S. Wells , Jeffrey S. Ginsberg , David R. Anderson , Clive Kearon , Michael Gent , Alexander G. Turpie , Janis Bormanis , Jeffrey Weitz , Michael Chamberlain , Dennis Bowie , David Barnes , and Jack Hirsh d-Dimer for the Exclusion of Acute Venous Thrombosis and Pulmonary Embolism Paul D. Stein , Russell D. Hull , Kalpesh C. Patel , Ronald E. Olson , William A. Ghali , Rollin Brant , Rita K. Biel , Vinay Bharadia , and Neeraj K. Kalra d-Dimer and Venous Thromboembolism Grégoire Le Gal , Marc Righini , and Henri Bounameaux d-Dimer and Venous Thromboembolism John T. Philbrick , Steven Heim , and Joel M. Schectman d-Dimer and Venous Thromboembolism Fabio Puglisi and Edda Federico d-Dimer and Venous Thromboembolism Russell D. Hull , William A. Ghali , Rollin F. Brant , and Paul D. Stein Metrics 21 September 2004Volume 141, Issue 6Page: 481KeywordsConfidence limitD-dimerDeep vein thrombosisEnzyme linked immunosorbent assayLikelihood ratioPulmonary embolismSystematic reviewsVenous thromboembolism ePublished: 21 September 2004 Issue Published: 21 September 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...