The Role of Qualitative D-Dimer Assays, Clinical Probability, and Noninvasive Imaging Tests for the Diagnosis of Deep Vein Thrombosis and Pulmonary Embolism

Abstract

Recent advances in the management of patients with suspected venous thromboembolism have both improved diagnostic accuracy as well as made management algorithms safer and more accessible. It is now clear that determination of clinical probability prior to diagnostic testing will improve patient management. D-dimer testing can be employed to decrease the need for imaging tests. Patients at low risk with a negative qualitative D-dimer can avoid imaging tests. Imaging test interpretation benefits from consideration of pretest probability also as this helps clinicians determine when a test may be falsely negative or falsely positive. Diagnostic strategies should include pretest clinical probability, D-dimer assays, and noninvasive imaging tests.