ArticleEmergency medicine international2026
Interpreting Near-Threshold Age-Adjusted D-Dimer for Suspected Pulmonary Embolism in the Emergency Department: A Retrospective Diagnostic Accuracy Study.
Article in Emergency medicine international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Interpreting Near-Threshold Age-Adjusted D-Dimer for Suspected Pulmonary Embolism in the Emergency Department: A Retrospective Diagnostic Accuracy Study.Emergency medicine international · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Age-adjusted D-dimer (AAD) thresholds are used to reduce false positives in older patients evaluated for pulmonary embolism (PE). However, evidence is limited regarding test behavior near the individualized cutoff ("near-threshold" zone) and the safety of excluding PE in AAD-negative cases. Methods: We conducted a retrospective diagnostic accuracy study of adults ≥ 50 years presenting to a tertiary emergency department (2015-2019) with suspected PE who underwent D-dimer testing and definitive imaging (CT pulmonary angiography or V/Q scintigraphy). Diagnostic performance of the standard threshold (0.5 µg/mL, FEU) and AAD (age × 0.01 µg/mL) was assessed using ROC analysis. Accuracy metrics are reported with 95% confidence intervals (CIs) via bootstrap; AUC CIs and between-curve comparisons used the DeLong method. The near-threshold zone was defined as ±0.1 µg/mL around the AAD cutoff. Clinical charts of AAD-negative PE cases were reviewed. Results: Among 979 patients, 162 (16.5%) had imaging-confirmed PE. Standard D-dimer showed sensitivity 99.4% (95% CI 98.0-100.0) and specificity 4.0% (2.7-5.4); AAD showed sensitivity 97.5% (94.8-99.4) and specificity 11.8% (9.6-13.9). AUCs were 0.734 and 0.727, with no significant difference (DeLong Conclusion: In this imaging-selected retrospective cohort, AAD improved specificity with minimal sensitivity loss. However, AAD should not be used as a stand-alone rule-out strategy and should be applied only within clinical probability-guided diagnostic pathways. Near-threshold results are not risk-free, particularly in older adults, and should prompt careful clinical reassessment when overall probability remains concerning.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.