Comparison of high specificity with standard versions of a quantitative latex D-dimer test in the assessment of community pulmonary embolism: HaemosIL D-dimer HS and pulmonary embolism

Than, Martin P., Helm, Jennifer, Calder, Kristi, Ardagh, Michael W., Smith, Mark, Dylan F. Flaws, and Beckert, Lutz (2009) Comparison of high specificity with standard versions of a quantitative latex D-dimer test in the assessment of community pulmonary embolism: HaemosIL D-dimer HS and pulmonary embolism. Thrombosis Research, 124 2: 230-235.


Author Than, Martin P.
Helm, Jennifer
Calder, Kristi
Ardagh, Michael W.
Smith, Mark
Dylan F. Flaws,
Beckert, Lutz
Title Comparison of high specificity with standard versions of a quantitative latex D-dimer test in the assessment of community pulmonary embolism: HaemosIL D-dimer HS and pulmonary embolism
Journal name Thrombosis Research  (ERA 2012 Listed)    (ERA 2010 Rank B)   Check publisher's open access policy
Publication date 2009-06
Sub-type Article
DOI 10.1016/j.thromres.2008.10.018
Volume number 124
Issue number 2
ISSN 0049-3848; 1879-2472
Start page 230
End page 235
Total pages 6
Place of publication East Park, Kidlington, Oxford, U.K.
Publisher Pergamon
Language eng
Formatted abstract Background: D-dimer assays are sensitive but have poor specificity. False positive results lead to extra imaging and hospital admissions.

Objectives: To make a pilot comparison of the diagnostic accuracy of the standard quantitative latex HemosIL D-dimer assay with a newer HemosIL D-dimer HS version designed to have improved specificity.

Patients / Methods: Consecutive patients presenting from the community to an Emergency Department that were investigated for suspected pulmonary embolism using a D-dimer test were included in the study. Standard and D-dimer HS tests were performed. Pulmonary Embolism was diagnosed on the basis of imaging studies or post-mortem at any time from presentation to 90 days thereafter.

Results: The prevalence of Pulmonary Embolism was 4.5% (18/402). The sensitivity, specificity, negative predictive value, and positive predictive value for the standard quantitative D-dimer test was 100% (81.5 – 100.0), 49.2% (44.1 – 54.3),100% (98.1 – 100.0), and 8.5% (5.1 – 13.0), respectively, and 100% (81.5 – 100.0), 58.3% (53.2 – 63.3),100% (98.4 – 100.0), and 10.1% (6.1 – 15.5), for the D-dimer HS test. There were 35 (16%) fewer ‘false positives’ using the D-dimer HS assay compared with the standard assay.

Conclusions: D-dimer HS has superior specificity to the standard quantitative D-dimer test without any loss of sensitivity. The generation of fewer false positive results should lead to less unnecessary diagnostic imaging; the use of which is associated with increased hospital admissions and length of stay. The HS assay may therefore have significant health economic benefits.
© 2008 Elsevier Ltd. All rights reserved.
Keyword D-dimer
Pulmonary embolism
Thromboembolism
Sensitivity
Specificity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article
Collection: School of Nursing and Midwifery Publications
 
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Created: Thu, 24 Mar 2011, 20:49:38 EST by Mr Dylan Flaws on behalf of School of Nursing and Midwifery