Evaluation of a Quantitative D-Dimer Latex Immunoassay for Acute Pulmonary Embolism Diagnosed by Computed Tomographic Angiography

2007 ◽  
Vol 82 (5) ◽  
pp. 556-560 ◽  
Author(s):  
David A. Froehling ◽  
Paul R. Daniels ◽  
Stephen J. Swensen ◽  
John A. Heit ◽  
Jayawant N. Mandrekar ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
D Dimer

Combination of D-Dimer and Amino-Terminal Pro-B-Type Natriuretic Peptide Testing for the Evaluation of Dyspneic Patients With and Without Acute Pulmonary Embolism

2006 ◽  
Vol 130 (9) ◽  
pp. 1326-1329
Author(s):  
Stacy E. F. Melanson ◽  
Michael Laposata ◽  
Carlos A. Camargo, Jr ◽  
Annabel A. Chen ◽  
Roderick Tung ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Negative Predictive Value ◽  
Natriuretic Peptide ◽  
Predictive Value ◽  
Acute Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Amino Terminal ◽  
Tomographic Angiography ◽  
D Dimer

Abstract Context.—D-dimer concentration can be used to exclude a diagnosis of acute pulmonary embolism. However, clinicians frequently order unnecessary supplemental testing in patients with low concentrations of D-dimer. Elevations in natriuretic peptides have also been described in the setting of pulmonary embolism. Objective.—We investigated the integrative role of D-dimer with amino-terminal pro-B-type natriuretic peptide for the evaluation of patients with and without acute pulmonary embolism. Design.—Patients were selected for analysis from a previous study in which levels of D-dimer and amino-terminal pro-B-type natriuretic peptide were measured. The presence of pulmonary embolism was determined by computed tomographic angiography. Results.—The median levels of D-dimer were significantly higher in patients with acute pulmonary embolism. Similarly, the median levels of amino-terminal pro-B-type natriuretic peptide were higher in patients with pulmonary embolism. Conclusions.—The Roche Tina-quant D-Dimer immunoturbidimetric assay provides a high negative predictive value and can be used to exclude acute pulmonary embolism in patients with dyspnea. Measurement of amino-terminal pro-B-type natriuretic peptide in addition to D-dimer improves specificity for acute pulmonary embolism without sacrificing negative predictive value. A combination of both markers may offer reassurance for excluding acute pulmonary embolism, and thus avoid redundant, expensive confirmatory tests.

Dose Reduction in Computed Tomographic Angiography of Pregnant Patients With Suspected Acute Pulmonary Embolism

2009 ◽  
Vol 33 (6) ◽  
pp. 961-966 ◽  
Author(s):  
Diana Litmanovich ◽  
Phillip M. Boiselle ◽  
Alexander A. Bankier ◽  
Milliam L. Kataoka ◽  
Oleg Pianykh ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Dose Reduction ◽  
Acute Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography

Computed Tomographic Angiography in Acute Pulmonary Embolism

2008 ◽  
Vol 32 (3) ◽  
pp. 438-443 ◽  
Author(s):  
Ehab M. Kamel ◽  
Sabine Schmidt ◽  
Francesco Doenz ◽  
Ghazal Adler-Etechami ◽  
Pierre Schnyder ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography

Diagnosis of Posttraumatic Pulmonary Embolism: Is Chest Computed Tomographic Angiography Acceptable?

2003 ◽  
Vol 54 (3) ◽  
pp. 472-477 ◽  
Author(s):  
John T. Anderson ◽  
Tina Jenq ◽  
Martin Bain ◽  
Robert Jacoby ◽  
Robert Osnis ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography

scholarly journals The Burden of Unnecessary Testing From a Regularly Ordered Laboratory Assay: Age-Adjusted d-Dimer Quality Improvement Study

2020 ◽  
Vol 26 ◽  
pp. 107602962093918
Author(s):  
Marcel M. Letourneau ◽  
Marc Zughaib ◽  
Abeer Berry ◽  
Marcel Zughaib
Keyword(s):  
Quality Improvement ◽  
Cost Benefit ◽  
Computed Tomographic Angiography ◽  
Internal Quality ◽  
The Novel ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Unnecessary Testing ◽  
D Dimer ◽  
Rule Out

Diagnosing acute pulmonary embolism (PE) involves clinical suspicion in combination with sequential diagnostic tests including d-dimer laboratory assays. Although the sensitivity of this assay is well validated and thoroughly tested, a false-positive result can lead to unnecessary and costly testing. The age-adjusted d-dimer (AADD) has been suggested in the literature to improve the usefulness of d-dimer cutoffs and safely decrease iodine and radiation exposure associated with definitively ruling out PE with computed tomographic angiography (CTA).1 We present an internal retrospective review utilizing the novel AADD cutoff to rule out PE and evaluate the potential extent of unnecessary testing with CTA. Using the AADD cutoff would have led to a 21.2% reduction in computerized tomography pulmonary embolus protocol. This internal quality improvement study suggests that changing our institutional conventional d-dimer to the novel AADD would provide a superior quality and cost–benefit.

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