Role of D-dimer in suspected thromboembolism

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D-dimer testing is now routinely done in the emergency department. How should the results be interpreted in the setting of a patient presenting with possible thromboembolism?
—Erik L. Schuls, MD, Gastonia, N.C.

The very high sensitivity and negative predictive value of certain D-dimer assays make them useful to help rule out thromboembolism in patients with a low clinical pretest probability for this condition. However, a D-dimer determination is generally not specific enough (particularly in patients who have had recent surgery) to rule in this diagnosis. An excellent review can be found in Ann Intern Med. 2004; 140:589-602.
—Daniel G. Tobin, MD (117-5)

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