Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability

• Published in: The New England journal of medicine Vol. 381; no. 22; pp. 2125 - 2134
• Main Authors: Kearon, Clive, de Wit, Kerstin, Parpia, Sameer, Schulman, Sam, Afilalo, Marc, Hirsch, Andrew, Spencer, Frederick A, Sharma, Sangita, D’Aragon, Frédérick, Deshaies, Jean-François, Le Gal, Gregoire, Lazo-Langner, Alejandro, Wu, Cynthia, Rudd-Scott, Lisa, Bates, Shannon M, Julian, Jim A
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 28.11.2019
• Subjects: Adult; Aged; Algorithms; Angiography; Anticoagulants; Chest; Clinical Decision Rules; Computed tomography; Computed Tomography Angiography; Consent; Diagnosis; Diagnostic tests; Embolism; Embolisms; Enrollments; Female; Fibrin Fibrinogen Degradation Products - analysis; Health risk assessment; Humans; Male; Medical diagnosis; Medical imaging; Medical research; Middle Aged; Patients; Predictive Value of Tests; Probability; Prospective Studies; Pulmonary Embolism - blood; Pulmonary Embolism - diagnosis; Pulmonary Embolism - diagnostic imaging; Pulmonary embolisms; Thromboembolism; Canada; North America; Europe

Among patients with a low clinical pretest probability of pulmonary embolism and a d -dimer level of less than 1000 ng per milliliter (twice the usual threshold used to rule out the disorder), the need for diagnostic imaging was reduced from 51.9% to 34.3% of patients, without increasing the risk of...