From the Sheffield Emergency Medicine Course for
A&E Consultants the following was quoted.
"In patients with a moderate or high clinical
probability and a negative D-dimer the risk of missing a DVT / PE is 1 in 50 and
1 in 5 respectively. A negative D-dimer in a patient with a low clinical
probability will miss < 1%. So using a D-dimer to screen the high risk group
is playing Russian Roulette."
I think our Radiology colleagues don't understand
the evidence... if the above is correct.
Ray McGlone
----- Original Message -----
Sent: Sunday, October 06, 2002 12:10
AM
Subject: Re: D-dimers and DVT
Our radiologists now
won't do a doppler unless a D-dimer is done and are very reluctant to do one
if the result is < 800 even if it is clinically a DVT. This week had a barn
door DVT that was refused a doppler before the D-dimer - the reading came back
> 6000!!
John
Dr John Hall DIMC RCS (Ed)
Hon.
Lecturer in Emergency Care
University of Birmingham
