[Relevance of adjusting the D-dimer test positivity threshold according to age in patients at low risk of venous thromboembolic events]

Bussières M, L'Espérance S, Coulombe M, Rhainds M, Lacasse Y
Record ID 32018005132
French
Original Title: Pertinence d’ajuster le seuil de positivité du test de D-dimères en fonction de l’âge chez les patients à faible risque d’évènements thromboemboliques veineux
Authors' objectives: Evidence from a review supports the use of an age-adjusted cut-off for D-dimer measurement when determining the risk of venous thromboembolic events in patients over 50 years of age. However, none of the included primary studies evaluated the diagnostic performance of the D-dimer assay by first adjusting the positivity threshold for age. Only one prospective study has been published to date. The results show that adjusting the D-dimer positivity threshold could potentially benefit a small sample of the target population. In addition, the numerous methodological shortcomings as well as the clinical heterogeneity limit the scope of the results and introduce uncertainty regarding the feasibility of applying this procedure in current clinical practice.
Authors' results and conclusions: The analysis of all the available data reveals that the D-dimer test is one of the components of a clinical decision-making algorithm used when evaluating the risk of venous thromboembolic events in the emergency department. In addition, the results indicate that adjusting the D-dimer positivity threshold according to patient age is currently a practice with undemonstrated clinical relevance.
Authors' recommendations: The assessment of the evidence led the Quebec Heart and Lung Institute – Laval University’s Health Technology Assessment Committee to recommend against the introduction, for the moment, of a practice of adjusting the D-dimer positivity threshold according to the patient’s age in the emergency setting.
Details
Project Status: Completed
URL for project: https://iucpq.qc.ca/fr/institut/qualite-et-performance/evaluation-des-technologies-et-modes-d-intervention-en-sante-etmis/accueil
Year Published: 2016
URL for published report: https://iucpq.qc.ca/sites/default/files/2016-02_rap_d-dimeres_iucpq.pdf
English language abstract: There is no English language summary available
Publication Type: Full HTA
Country: Canada
Province: Quebec
MeSH Terms
  • Pulmonary Embolism
  • Diagnostic Tests, Routine
  • Venous Thromboembolism
  • Fibrin Fibrinogen Degradation Products
  • Predictive Value of Tests
Contact
Organisation Name: Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval (IUCPQ-ULaval)
Contact Address: 2725, chemin Sainte-Foy Québec QC G1V 4G5
Contact Name: uetmis.iucpq@ssss.gouv.qc.ca
Contact Email: uetmis.iucpq@ssss.gouv.qc.ca
Copyright: Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.