New Guidelines Issued for Venous Thromboembolism

New Guidelines Issued for Venous Thromboembolism - CME Teaching Brief® - MedPage Today: "Other conclusions were as follows:

* Fifteen studies support that when a D-dimer assay is negative and a clinical prediction rule suggests a low probability of DVT or pulmonary embolism, the negative predictive value is high enough to justify forgoing imaging studies in many patients.
* The evidence in five systematic reviews regarding the use of D-dimer, in isolation, is strong and demonstrates sensitivities of the enzyme-linked immunosorbent assay (ELISA) and quantitative rapid ELISA, pooled across studies, of approximately 95%.
* Eight systematic reviews found that the sensitivity and specificity of ultrasonography for diagnosis of DVT vary by vein. Ultrasonography performs best for diagnosis of symptomatic, proximal vein thrombosis, with pooled sensitivities of 89% to 96%.
* The sensitivity of single-detector helical computed tomography for diagnosis of pulmonary embolism varied widely across studies and was below 90% in four of nine studies. More studies are needed to determine the sensitivity of multidetector scanners."