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

Published on: November 14, 2017
Project Number: RC0940-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

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.

Tags

blood, fibrin fibrinogen degradation products, point-of-care systems, medical devices, respiratory, rapid test, bedside, rapid diagnostic test