D‐Dimer tests for the diagnosis of deep venous thrombosis in symptomatic hospital outpatients with a clinical prediction rule

Published on Sep 14, 2016in Cochrane Database of Systematic Reviews7.89
· DOI :10.1002/14651858.CD012356
Francesca M Chappell30
Estimated H-index: 30
(Edin.: University of Edinburgh),
Alina Andras11
Estimated H-index: 11
(Keele University)
+ 4 AuthorsFay Crawford20
Estimated H-index: 20
(Queen Margaret Hospital)
This is the protocol for a review and there is no abstract. The objectives are as follows: To estimate the sensitivity and specificity of the various types of D-dimer test in the diagnosis of deep vein thrombosis (DVT) of the lower limb in symptomatic outpatients with a clinical prediction rule score. Patients' clinical prediction rule scores will be used to assess D-dimer test accuracy in different risk groups. To investigate the following as potential sources of heterogeneity: age, sex, cancer, previous venous thromboembolism (VTE), prolonged immobilisation, anticoagulant treatment, time lapse between onset of symptoms and testing, and type of reference standard. However, we recognise that all of these listed items, except type of reference standard, are patient-specific rather than study-specific, and so study reports may lack the necessary level of detail to enable an informative analysis.
📖 Papers frequently viewed together
88 Citations
74 Citations
2 Citations
#1Fay Crawford (Queen Margaret Hospital)H-Index: 20
#2Alina Andras (Freeman Hospital)H-Index: 11
Last. Francesca M Chappell (Edin.: University of Edinburgh)H-Index: 30
view all 6 authors...
Background Pulmonary embolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms such as difficulty breathing, chest pain and an increased respiratory...
47 CitationsSource
#1Gary E. Raskob (University of Oklahoma Health Sciences Center)H-Index: 89
Last. Jeffrey I. WeitzH-Index: 109
view all 13 authors...
Background— Thrombosis is the common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Disease Study 2010 (GBD 2010) documented that ischemic heart disease and stroke collectively caused 1 in 4 deaths worldwide. GBD 2010 did not report data for VTE as a cause of death and disability. Objective— To review the literature on the global burden of disease caused by VTE. Approach and Results— We performed a systematic review of the lit...
341 CitationsSource
#1Francesca M Chappell (Edin.: University of Edinburgh)H-Index: 30
#2Fay Crawford (Freeman Hospital)H-Index: 20
Last. Crispian OatesH-Index: 2
view all 7 authors...
This is the protocol for a review and there is no abstract. The objectives are as follows: To estimate the sensitivity and specificity of duplex ultrasound for the detection of distal and proximal DVT in symptomatic patients with prior testing by a clinical prediction rule (with or without additional D-dimer testing). The accuracy of ultrasound for DVT may be affected by body mass index and whether the patient has had a previous DVT. If possible, we shall investigate both previous DVT and body m...
4 CitationsSource
#1Henrike J. Schouten (UU: Utrecht University)H-Index: 4
#2Geert-Jan Geersing (UU: Utrecht University)H-Index: 19
Last. Johannes B. Reitsma (UU: Utrecht University)H-Index: 110
view all 9 authors...
Objective To review the diagnostic accuracy of D-dimer testing in older patients (>50 years) with suspected venous thromboembolism, using conventional or age adjusted D-dimer cut-off values. Design Systematic review and bivariate random effects meta-analysis. Data sources We searched Medline and Embase for studies published before 21 June 2012 and we contacted the authors of primary studies. Study selection Primary studies that enrolled older patients with suspected venous thromboembolism in who...
193 CitationsSource
#1Samuel Z. Goldhaber (Brigham and Women's Hospital)H-Index: 132
#2Henri BounameauxH-Index: 85
Summary Pulmonary embolism is the third most common cause of death from cardiovascular disease after heart attack and stroke. Sequelae occurring after venous thromboembolism include chronic thromboembolic pulmonary hypertension and post-thrombotic syndrome. Venous thromboembolism and atherothrombosis share common risk factors and the common pathophysiological characteristics of inflammation, hypercoagulability, and endothelial injury. Clinical probability assessment helps to identify patients wi...
570 CitationsSource
#1Penny Whiting (UoB: University of Bristol)H-Index: 53
#2Anne W S RutjesH-Index: 55
Last. Patrick M.M. BossuytH-Index: 147
view all 9 authors...
In 2003, the QUADAS tool for systematic reviews of diagnostic accuracy studies was developed. Experience, anecdotal reports, and feedback suggested areas for improvement; therefore, QUADAS-2 was developed. This tool comprises 4 domains: patient selection, index test, reference standard, and flow and timing. Each domain is assessed in terms of risk of bias, and the first 3 domains are also assessed in terms of concerns regarding applicability. Signalling questions are included to help judge risk ...
5,608 CitationsSource
#1Penny Whiting (UoB: University of Bristol)H-Index: 53
#2Marie WestwoodH-Index: 35
Last. Julie Glanville (Ebor: University of York)H-Index: 41
view all 6 authors...
Abstract Objective To compare the performance of MEDLINE searches using index test(s) and target condition (subject searches) with the same searches combined with methodological filters for test accuracy studies. Study Design and Setting We derived a reference set of 506 test accuracy studies indexed on MEDLINE from seven systematic reviews that conducted extensive searches. We compared the performance of “subject” with “filtered” searches (same searches combined with each of 22 filters). Outcom...
88 CitationsSource
#1Marcello Di NisioH-Index: 34
#2Patrick M.M. Bossuyt (UvA: University of Amsterdam)H-Index: 147
Last. Anne W S Rutjes (University of Bern)H-Index: 55
view all 7 authors...
2 CitationsSource
#1E. Ceriani (Geneva College)H-Index: 1
#2Christophe Combescure (Geneva College)H-Index: 56
Last. Marc Philip Righini (Geneva College)H-Index: 61
view all 8 authors...
SUMMARY BACKGROUND: Pretest probability assessment is necessary to identify patients in whom pulmonary embolism (PE) can be safely ruled out by a negative D-dimer without further investigations. OBJECTIVE: Review and compare the performance of available clinical prediction rules (CPRs) for PE probability assessment. PATIENTS/METHODS: We identified studies that evaluated a CPR in patients with suspected PE from Embase, Medline and the Cochrane database. We determined the 95% confidence intervals ...
201 CitationsSource
#1David Moher (Ottawa Hospital Research Institute)H-Index: 129
#2Alessandro Liberati (Cochrane Collaboration)H-Index: 16
Last. Douglas G. Altman (University of Oxford)H-Index: 268
view all 4 authors...
David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
39.6k CitationsSource
Cited By1
Modern diagnostic strategies of venous thromboembolism (VTE) have been developed. In this review, the diagnostic algorithms for deep-vein thrombosis (DVT) and their parameters are discussed individually in the context of reporting a case of DVT in a 43-year-old Caucasian female with a moderate pretest probability stratified by Wells' score and a negative high quality D-dimer test. The patient was on treatment with Xarelto (rivaroxaban), 20 mg PO daily at the time of presentation. The diagnosis w...