Point-Of-Care D-Dimer Testing: A Review of Diagnostic Accuracy, Clinical Utility, and Safety


( Last Updated : November 14, 2017)
Project Line:
Health Technology Review
Project Sub Line:
Summary with Critical Appraisal
Project Number:
RC0940-000

Details


Question


  1. What is the diagnostic test accuracy of diagnostic pathways involving a clinical prediction rule in combination with point-of-care D-dimer testing in adult patients presenting with pulmonary embolism symptoms?

  2. What is the clinical utility of diagnostic pathways involving a clinical prediction rule in combination with point-of-care D-dimer testing in adult patients presenting with pulmonary embolism symptoms?

  3. What is the safety of diagnostic pathways involving a clinical prediction rule in combination with point-of-care D-dimer testing in adult patients presenting with pulmonary embolism symptoms?


Key Message

In adult patients presenting from the community with symptoms of pulmonary embolism and a low pre-test probability based on the Wells score, a negative point of care D-dimer test demonstrated good diagnostic accuracy with high sensitivity and negative predictive value for pulmonary embolism compared to standard care. In elderly patients presenting from the community or a nursing home, the sensitivity and negative predictive value were slightly lower. A lower Wells score cut off improved the sensitivity and clinical utility of point of care D-dimer testing. There were no studies which addressed the safety of POC D-dimer testing in adult patients presenting with symptoms of pulmonary embolism that met the inclusion criteria.