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Is D-dimer used according to clinical algorithms in the diagnostic work-up of patients with suspicion of venous thromboembolism? A study in six European countries

2016-06Journal article Restricted access
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dc.contributor.authorKristoffersen, Ann Helen
dc.contributor.authorAjzner, Eva
dc.contributor.authorRogic, Dunja
dc.contributor.authorSozmen, Eser Y.
dc.contributor.authorCarraro, Paolo
dc.contributor.authorFaria, Ana Paula
dc.contributor.authorWatine, Joseph
dc.contributor.authorMeijer, Piet
dc.contributor.authorSandberg, Sverre
dc.contributor.authorjoint Working Group on Postanalytical Phase (WG-POST) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM).
dc.date.accessioned2018-03-01T18:43:27Z
dc.date.available2020-04-07T00:30:15Z
dc.date.issued2016-06
dc.description.abstractIntroduction: Clinical algorithms consisting of pre-test probability estimation and D-dimer testing are recommended in diagnostic work-up for suspected venous thromboembolism (VTE). The aim of this study was to explore how physicians working in emergency departments investigated patients suspected to have VTE. Materials and methods: A questionnaire with two case histories related to the diagnosis of suspected pulmonary embolism (PE) (Case A) and deep venous thrombosis (DVT) (Case B) were sent to physicians in six European countries. The physicians were asked to estimate pre-test probability of VTE, and indicate their clinical actions. Results: In total, 487 physicians were included. Sixty percent assessed pre-test probability of PE to be high in Case A, but 7% would still request only D-dimer and 11% would exclude PE if D-dimer was negative, which could be hazardous. Besides imaging, a D-dimer test was requested by 41%, which is a “waste of resources” (extra costs and efforts, no clinical benefit). For Case B, 92% assessed pre-test probability of DVT to be low. Correctly, only D-dimer was requested by 66% of the physicians, while 26% requested imaging, alone or in addition to D-dimer, which is a “waste of resources”. Conclusions: These results should encourage scientific societies to improve the dissemination and knowledge of the current recommendations for the diagnosis of VTE.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationThromb Res. 2016 Jun;142:1-7. doi:10.1016/j.thromres.2016.04.001. Epub 2016 Apr 6pt_PT
dc.identifier.doi10.1016/j.thromres.2016.04.001pt_PT
dc.identifier.issn0049-3848
dc.identifier.urihttp://hdl.handle.net/10400.18/5116
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier/European Thrombosis Research Organisation (ETROpt_PT
dc.relation.publisherversionhttp://dx.doi.org/10.1016/j.thromres.2016.04.001pt_PT
dc.subjectVenous Thromboembolismpt_PT
dc.subjectClinical Decision Rulespt_PT
dc.subjectD-dimerpt_PT
dc.subjectPre-test Probabilitypt_PT
dc.subjectClinical Algorithmspt_PT
dc.subjectAvaliação Externa da Qualidadept_PT
dc.subjectPrograma Nacional de Avaliação Externa da Qualidadept_PT
dc.subjectPNAEQpt_PT
dc.subjectAEQpt_PT
dc.titleIs D-dimer used according to clinical algorithms in the diagnostic work-up of patients with suspicion of venous thromboembolism? A study in six European countriespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage7pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleThrombosis Researchpt_PT
oaire.citation.volume142pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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