Trial reportAnnals of internal medicine2004
Negative D-dimer result to exclude recurrent deep venous thrombosis: a management trial.
Trial report in Annals of internal medicine, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03868956 (Safety of a Management Strategy Based on Colour Doppler ULTrasound and D-Dimer Testing for the Diagnosis Exclusion of RECurrent Deep Vein Thrombosis of the Lower Limbs. The ULTREC Project), which is not on this map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Safety of a Management Strategy Based on Colour Doppler ULTrasound and D-Dimer Testing for the Diagnosis Exclusion of RECurrent Deep Vein Thrombosis of the Lower Limbs. The ULTREC Project
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review of the Predictive Value of Plasma D-Dimer Levels for Predicting Stroke Outcome.Frontiers in neurology · 2021Pooled it
- Guideline
- Safety of a strategy combining D-dimer testing and whole-leg ultrasonography to rule out deep vein thrombosis.Blood advances · 2020Trial
- Mean platelet volume and D-dimer in patients with suspected deep venous thrombosis.Journal of thrombosis and thrombolysis · 2012Trial
- Multiple biomarkers risk score for accurately predicting the long-term prognosis of patients with acute coronary syndrome.Journal of geriatric cardiology : JGC · 2025Article
- Asymptomatic Venous Thromboembolism After Hepatobiliary-Pancreatic Surgery: Early Detection Using D-dimer and Soluble Fibrin Monomer Complex Levels.Annals of gastroenterological surgery · 2022Article
- Current Challenges in Diagnosis of Venous Thromboembolism.Journal of clinical medicine · 2020Review
- Safety of using the combination of the Wells rule and D-dimer test for excluding acute recurrent ipsilateral deep vein thrombosis.Journal of thrombosis and haemostasis : JTH · 2020Article
- Thrombosis risk factors in PIK3CA-related overgrowth spectrum and Proteus syndrome.American journal of medical genetics. Part C, Seminars in medical genetics · 2019Article
- Characterization of thrombosis in patients with Proteus syndrome.American journal of medical genetics. Part A · 2017Article
- Effectiveness of d-dimer as a screening test for venous thromboembolism: an update.North American journal of medical sciences · 2014Review
- Predictive value of D-dimer test for recurrent venous thromboembolism at hospital discharge in patients with acute pulmonary embolism.Journal of thrombosis and thrombolysis · 2011Article
- Predictive value of D-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis.World journal of gastroenterology · 2007Article
- Advances in the diagnosis of venous thromboembolism.Journal of thrombosis and thrombolysis · 2006Review
Corrections and comments
- SummaryForPatientsIn
Authors and funding
3 authors.
Funding
Abstract
backgroundAll of the available diagnostic tests for deep venous thrombosis (DVT) have limitations for excluding acute recurrent DVT. Measurement of plasma d-dimer by using an automated quantitative assay may be useful as a rapid exclusion test in patients with suspected recurrent DVT.
objectiveTo test the safety of withholding additional diagnostic testing and heparin treatment in patients who have a negative d-dimer result at presentation (using the automated quantitative assay STA-Liatest D-di), regardless of their symptoms.
designProspective cohort study.
settingAcademic medical center in the United States. PATIENTS: 300 consecutive patients with suspected recurrent DVT.
interventionPatients underwent d-dimer testing at presentation. In patients with negative D-dimer results, heparin therapy was withheld, and no further diagnostic testing for DVT was done as part of the initial evaluation. Patients with positive D-dimer results underwent compression ultrasonography. MEASUREMENTS: The primary outcome measure was a diagnosis of new symptomatic venous thromboembolism confirmed by diagnostic testing during the 3-month follow-up period.
resultsOf the 300 study patients, the d-dimer result was negative at presentation in 134 patients (45%; negative cohort) and positive at presentation in 166 patients. Of the 166 patients, compression ultrasonography documented new DVT in 54 patients. Compression ultrasonography findings were normal in 79 patients and were inconclusive in 33 patients. After 3 months of follow-up, 1 of 134 patients in the negative cohort had confirmed venous thromboembolism (0.75% [95% CI, 0.02% to 4.09%]). Venous thromboembolism on follow-up could not be definitively excluded in 5 patients with recurrent leg symptoms and in 1 patient who died. If these patients are considered to have venous thromboembolism, the incidence during the 3-month follow-up period would be 6.0% (CI, 2.6% to 11.4%) (8 of 134 patients). LIMITATIONS: There is no accepted diagnostic reference standard for recurrent DVT. The precision of the estimate of the incidence of venous thromboembolism on follow-up and the generalizability to settings other than an academic health center should be evaluated.
conclusionsMeasurement of plasma d-dimer by using the automated quantitative assay STA-Liatest D-di seems to provide a simple method for excluding acute recurrent DVT in symptomatic patients.
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