VIDAS D-dimer in combination with clinical pre-test probability to rule out pulmonary embolism. A systematic review of management outcome studies
| العنوان: | VIDAS D-dimer in combination with clinical pre-test probability to rule out pulmonary embolism. A systematic review of management outcome studies |
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| المؤلفون: | Marc Philip Righini, Philip S. Wells, Marc Carrier, Walter A. Wuillemin, Arnaud Perrier, Marc A. Rodger, Menno V. Huisman, Grégoire Le Gal, Reza Karami Djurabi |
| المساهمون: | Clinical Epidemiology Unit, Ottawa-The Ottawa Hospital, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Service de médecine interne générale (SMIG), Ottawa Hospital, Thrombosis Program, University of Ottawa [Ottawa], Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Calvez, Ghislaine |
| المصدر: | Thrombosis and Haemostasis Thrombosis and Haemostasis, Schattauer, 2009, 101 (5), pp.886-92 Thrombosis and Haemostasis, Vol. 101, No 5 (2009) pp. 886-892 |
| بيانات النشر: | HAL CCSD, 2009. |
| سنة النشر: | 2009 |
| مصطلحات موضوعية: | Male, MESH: Pulmonary Embolism, 030204 cardiovascular system & hematology, MESH: Risk Assessment, law.invention, 0302 clinical medicine, MESH: Aged, 80 and over, Randomized controlled trial, law, Risk Factors, MESH: Risk Factors, Health Status Indicators, Pulmonary Embolism/*blood/*diagnosis/drug therapy/etiology, 030212 general & internal medicine, Biological Markers/blood, Geneva score, ddc:616, Aged, 80 and over, MESH: Aged, 0303 health sciences, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Hematology, MESH: Predictive Value of Tests, 3. Good health, Pulmonary embolism, Pre- and post-test probability, Anticoagulants/therapeutic use, Meta-analysis, Predictive value of tests, Female, medicine.medical_specialty, MESH: Anticoagulants, Risk Assessment, Sensitivity and Specificity, Fibrin Fibrinogen Degradation Products, Diagnosis, Differential, 03 medical and health sciences, Predictive Value of Tests, MESH: Diagnosis, Differential, Internal medicine, MESH: Health Status Indicators, D-dimer, medicine, MESH: Fibrin Fibrinogen Degradation Products, Humans, Fibrin Fibrinogen Degradation Products/*analysis, 030304 developmental biology, Aged, MESH: Humans, business.industry, MESH: Biological Markers, Anticoagulants, medicine.disease, Confidence interval, MESH: Male, MESH: Sensitivity and Specificity, Surgery, MESH: Gestalt Theory, Gestalt Theory, business, Pulmonary Embolism, MESH: Female, Biomarkers, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | SummaryClinical outcome studies have shown that it is safe to withhold anticoagulant therapy in patients with suspected pulmonary embolism (PE) who have a negative D-dimer result and a low pre-test probability (PTP) either using a PTP model or clinical gestalt. It was the objective of the present study to assess the safety of the combination of a negative VIDAS© D-dimer result in combination with a non-high PTP using the Wells or Geneva models to exclude PE. A systematic literature search strategy was conducted using MEDLINE, EMBASE, the Cochrane Register of Controlled Trials and all EBM Reviews. Seven studies (6 prospective management studies and 1 randomised controlled trial) reporting failure rates at three months were included in the analysis. Non-high PTP was defined as “unlikely” using the Wells’ model, or “low/intermediate” PTP using either the Geneva score, the Revised Geneva Score, or clinical gestalt. Two reviewers independently extracted data onto standardised forms. A total of 5,622 patients with low/intermediate or unlikely PTP were assessed using the VIDAS D-dimer. PE was ruled out by a negative D-dimer test in 2,248 (40%, 95% confidence intervals [CI] 38.7 to 41.3%) of them. The three-month thromboembolic risk in patients left untreated on the basis of a low/intermediate or unlikely PTP and a negative D-dimer test was 3/2,166 (0.14%, 95% CI 0.05 to 0.41%). In conclusion, the combination of a negative VIDAS D-dimer result and a non-high PTP effectively and safely excludes PE in an important proportion of outpatients with suspected PE. |
| اللغة: | English |
| تدمد: | 0340-6245 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::48d2d6bb01eba6e7a01c455aab131ad6Test https://hal.univ-brest.fr/hal-00683229Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....48d2d6bb01eba6e7a01c455aab131ad6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 03406245 |
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