Trial reportBMJ (Clinical research ed.)1998
D-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study. The Multicentre Italian D-dimer Ultrasound Study Investigators Group.
Trial report in BMJ (Clinical research ed.), 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Systematic review and meta-analysis of outcomes in patients with suspected deep vein thrombosis.Blood advances · 2020Pooled it
- Diagnosis of deep vein thrombosis of the lower extremity: a systematic review and meta-analysis of test accuracy.Blood advances · 2020Pooled it
- American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism.Blood advances · 2018Guideline
- Guideline
- Combined use of rapid D-dimer testing and estimation of clinical probability in the diagnosis of deep vein thrombosis: systematic review.BMJ (Clinical research ed.) · 2004Pooled it
- Safety of a strategy combining D-dimer testing and whole-leg ultrasonography to rule out deep vein thrombosis.Blood advances · 2020Trial
- Negative D-dimer result to exclude recurrent deep venous thrombosis: a management trial.Annals of internal medicine · 2004Trial
- Should we diagnose and treat distal deep vein thrombosis?Hematology. American Society of Hematology. Education Program · 2017Review
- Risk of Venous Thromboembolism after a Single Normal Proximal Lower Extremity Venous Ultrasound.The Permanente journal · 2017Article
- Emergency Department Management of Suspected Calf-Vein Deep Venous Thrombosis: A Diagnostic Algorithm.The western journal of emergency medicine · 2016Review
- Evaluating the Use of a Negative D-Dimer and Modified Low Wells Score in Excluding above Knee Deep Venous Thrombosis in an Outpatient Population, Assessing Need for Diagnostic Ultrasound.ISRN radiology · 2014Article
- Computed tomographic pulmonary angiography and pulmonary embolism: predictive value of a d-dimer assay.BMC research notes · 2012Article
- Reconstruction is not renovation - the role of remodeling in asthma.Journal of asthma and allergy · 2009Article
- [Diagnostic imaging of venous diseases. Part II: varicose veins, venous anomalies, and primary venous tumors].Der Radiologe · 2008Review
- [Diagnostic imaging of venous disease: Part I: methods in the diagnosis of veins and thrombosis].Der Radiologe · 2008Review
- D-dimer testing: advantages and limitations in emergency medicine for managing acute venous thromboembolism.Internal and emergency medicine · 2006Review
- Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis.BMC medical imaging · 2005Article
- Effects of prolonged strenuous exercise (marathon running) on biochemical and haematological markers used in the investigation of patients in the emergency department.British journal of sports medicine · 2004Article
- Role of fibrin D-dimer testing in emergency medicine.Emergency medicine journal : EMJ · 2003Review
- Diagnosis, investigation, and management of deep vein thrombosis.BMJ (Clinical research ed.) · 2003Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the efficacy of using a rapid plasma D-dimer test as an adjunct to compression ultrasound for diagnosing clinically suspected deep vein thrombosis.
designD-dimer concentrations were determined in all patients with a normal ultrasonogram at presentation. Repeat ultrasonography was performed 1 week later only in patients with abnormal D-dimer test results. MAIN OUTCOME AND MEASURES: Patients with normal ultrasonograms were not treated with anticoagulants and were followed for 3 months for thromboembolic complications.
settingUniversity research and affiliated centres. SUBJECTS: 946 patients with clinically suspected deep vein thrombosis.
resultsUltrasonograms were abnormal at presentation in 260 (27.5%) patients. Of the remaining 686 patients tested for D-dimer, 88 (12.8%) had abnormal concentrations. During follow up venous thromboembolic complications occurred in one of the 598 patients who were not treated with anticoagulants and who had an initial normal ultrasonogram and D-dimer concentration, whereas thromboembolic complications occurred in two of the 83 untreated patients who had abnormal D-dimer concentrations but a normal repeat ultrasonogram. The cumulative incidence of venous thromboembolic complications during follow up was 0.4% (95% confidence interval 0% to 0.9%). The rapid plasma D-dimer test used as an adjunct to compression ultrasonography resulted in a reduction in the mean number of repeat ultrasound examinations and additional hospital visits from 0.7 to 0.1 per patient.
conclusionsTesting for D-dimer as an adjunct to a normal baseline ultrasound examination decreased the number of subsequent ultrasound examinations considerably without any increased risk of venous thromboembolic complications in patients not receiving anticoagulants. The use of ultrasound and testing for D-dimer enabled treatment decisions to be made at the time of presentation in most patients.
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