D-dimer testing reduced the need for ultrasonographic imaging in outpatients with suspected deep venous thrombosis: COMMENTARY

Segal, Jodi B.
May 2004
ACP Journal Club;May/Jun2004, Vol. 140 Issue 3, p67
Academic Journal
Previous cohort studies have shown the usefulness of D-dimer testing along with an assessment of the clinical probability of disease to exclude a diagnosis of deep venous thrombosis (DVT). In this study, authors report the first randomized trial testing a diagnostic strategy incorporating D-dimer testing and convincingly show the value of this approach. Whereas the study was powered to show that the rate of DVT during follow-up would be D-dimer group than in the VUI group, the rate was actually 0.9% lower in the D-dimer group than in the VUI group, thus showing that the 2 approaches are equivalent in safety. Furthermore, fewer extremity ultrasonographic tests were done in the D-dimer group than in the VUI group. This implies that use of D-dimer testing may be cost-saving, although this observation needs formal testing.


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