ClinicalEight studies involving over a thousand patients showed that the sensitivity and specificity for D-dimer tests ranged from 75% to 100% and 26% to 83% respectively. For the purpose of ruling out DVT, this means that 0 to 25 out of 100 patients with the disease will be missed with a D-dimer test and this implies that this test can be considered for ruling out DVT in conjunction with another test, but not on its own. The specificity suggests that 17 to 74 out of 100 people without DVT will be identified as having the condition and this implies that this test is not suitable for the purpose of confirming the presence of DVT (VERY LOW QUALITY).

In a meta-analysis, evidence from 97 studies involving thousands of patients showed that the 95% CI for sensitivity and specificity for all D-dimer tests ranged from 90% to 91% and 54% to 55% respectively. For the purpose of ruling out DVT, this means that 9 to 10 out of 100 patients with the disease will be missed with all D-dimer tests. This implies that these tests can be considered for ruling out DVT in conjunction with another test. The specificity suggests that 45 to 46 out of 100 people without DVT will be identified as having the condition and this implies that this test is not suitable for the purpose of confirming the presence of DVT (LOW QUALITY).

A subgroup of this meta-analysis, which had included 58 studies involving thousands of patients showed that the 95% CI for sensitivity and specificity for ELISAs ranged from 93% to 95% and 44% to 46% respectively. For the purpose of ruling out DVT, this means that 5 to 7 out of 100 patients with the disease will be missed with a D-dimer test and this implies that this test can be considered for ruling out DVT in conjunction with another test. The specificity suggests that 54 to 56 out of 100 people without DVT will be identified as having the condition and this implies that this test is not suitable for the purpose of confirming the presence of DVT (LOW QUALITY).

A subgroup of this meta-analysis, which had included 52 studies involving thousands of patients, showed that the 95% CI for sensitivity and specificity for latex assays ranged from 88% to 90% and 54% to 56% respectively. For the purpose of ruling out DVT, this means that 10 to 12 out of 100 patients with the disease will be missed with a D-dimer test and this implies that this test can be considered for ruling out DVT in conjunction with another test. The specificity suggests that 44 to 46 out of 100 people without DVT will be identified as having the condition and this implies that this test is not suitable for the purpose of confirming the presence of DVT (LOW QUALITY).

A subgroup of this meta-analysis, which had 29 studies involving thousands patients showed that the 95% CI for sensitivity and specificity for whole blood agglutination ranged from 85% to 88% and 67% to 69% respectively. For the purpose of ruling out DVT, this means that 12 to 15 out of 100 patients with the disease will be missed with a D-dimer test and this implies that this test can be considered for ruling out DVT in conjunction with another test. The specificity suggests that 31 to 33 out of 100 people without DVT will be identified as having the condition and this implies that this test is not suitable for the purpose of confirming the presence of DVT(LOW QUALITY).
EconomicD-dimer is a component of a cost-effective diagnostic strategy. The cost of performing a D-dimer test is relatively low (between £19 and £20).

From: 5, Diagnosis of deep vein thrombosis

Cover of Venous Thromboembolic Diseases
Venous Thromboembolic Diseases: The Management of Venous Thromboembolic Diseases and the Role of Thrombophilia Testing [Internet].
NICE Clinical Guidelines, No. 144.
National Clinical Guideline Centre (UK).
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