Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—We agree with Dr Lippi et al regarding the potential value of the D-dimer assay in determining the posttest probability that a patient has DVT. Before diagnostic tests are performed, the algorithm presented in our article reliably stratifies patients into low, moderate, and high probability of having DVT. The additional benefit of a D-dimer assay to this model must be confirmed before we advocate widespread use of the model in combination with D-dimer analysis. Furthermore, the type of D-dimer assay used varies from center to center and therefore test properties vary. A study testing the clinical prediction guide in combination with a D-dimer assay is currently under way at my institution and its results will help define the role of D-dimer in the diagnosis of DVT.
Anand SS. Plasma D-Dimer in the Diagnosis of Deep Vein Thrombosis—Reply. JAMA. 1998;280(21):1828-1829. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-21-jbk1202