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Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients: Conclusion
However, this may not occur in real practice. For example, in the present study, although the Canadian score < 2 produced a pretest probability of 2.9%, the actual measured posttest probability of PE was 1.2% (95% CI, 0.8 to 2.0%). In our population, the < 1.0% posttest probability objective was met only when a negative […]
Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients: Discussion
Figure 3 shows the plot of the likelihood ratio as a function of prevalence (R2 = 0.006 with t test on slope yielding p = 0.85; power to detect a significant correlation of 29%). The Pearson correlation coefficient observed for the plot of sensitivity vs prevalence yielded R2 = 0.20, with p = 0.27 from […]
Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients: Results
The d-dimer assay was performed on 2,302 patients enrolled from October 1, 2001, until June 30, 2004. Clinical characteristics of the study population are shown in Table 1. PE was diagnosed in 108 patients (4.7%; 95% CI, 3.6 to 5.6%). Figure 1 shows the flow diagram of diagnostic imaging relevant to PE. One thousand two […]
Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients: Criterion Standard
Imaging was performed according to a flow diagram posted in the ED. The primary pulmonary vascular imaging study was CT angiography of the chest and venography of the legs, performed and interpreted as we have previously described. Patients who were allergic to iodinated contrast or had a serum creatinine measurement > 1.5 mg/dL underwent ventilation-perfusion […]
Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients: Materials and Methods
Typical indications for the PE rule-out protocol included symptoms of dyspnea, chest pain, or syncope, or physical signs such as a rapid pulse or low pulse oximetry reading that could not be explained by another disease process. Exclusions were hemodynamic instability (clinical signs of shock as described by Jones et al), inability to obtain a […]
Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients
The ideal screening strategy to exclude pulmonary embolism (PE) in the emergency department (ED) setting would be, fast, cheap, accurate, and easy to use. The d-dimer assay (Simplify D-dimer; Agen Biomedical; Brisbane, Australia) is a single-use, individually packaged immunofiltration cartridge assay. The kits and the reagents can be stored at room temperature. The user adds […]