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A Shortcut to Accurate Diagnosis?

Daniel M. Becker, MD, MPH; John T. Philbrick, MD; Tracy L. Bachhuber, MD; John E. Humphries, MD

Arch Intern Med. 1996;156(9):939-946.

Abstract
D -dimer fragments can be measured easily in plasma and whole blood, and the presence or absence of D-dimer could be useful in the diagnostic evaluation of venous thromboembolism. We systematically reviewed the English literature for articles that compared D-dimer results with those of other tests for deep venous thrombosis or pulmonary embolism. Twenty-nine studies were selected for detailed review, and we noted wide variability in assay performance, heterogeneity among subjects, and failure to define absence or presence of venous thromboembolism by a comprehensive criterion standard for diagnosis. These methodologic problems limit the generalizability of the published estimates of D-dimer accuracy for deep venous thrombosis or pulmonary embolism, and the clinical utility of this potentially important test remains unproved.

(Arch Intern Med. 1996;156:939-946)

Author Affiliations
From the Divisions of General Medicine (Drs Becker, Philbrick, and Bachhuber) and Hematology/Oncology (Dr Humphries), Department of Medicine, University of Virginia School of Medicine, Charlottesville.

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