Recurrent PE: D-dimer for patients with low clinical probability, CTPA for patients with low clinical probability and positive D-dimer, or high clinical probability sensitivity and specificity
| Test result . | No. of results per 1000 patients tested (95% CI) . | No. of participants (studies) . | Certainty of the evidence (GRADE) . | |
|---|---|---|---|---|
| Prevalence 30%*†‡ in patients suspected of having PE . | Prevalence 40%†‡§ in patients suspected of having PE . | |||
| True positives | 291 (282-294) | 388 (376-392) | 992 (3) | ⨁⨁⨁◯ MODERATE|| |
| False negatives | 9 (6-18) | 12 (8-24) | ||
| True negatives | 700 (693-700) | 600 (594-600) | 992 (3) | ⨁⨁⨁◯ MODERATE|| |
| False positives | 0 (0-7) | 0 (0-6) | ||
| Inconclusive test results | 3 | 992 (3) | — | |
| Complications arising from the diagnostic test | Not reported | |||
| Test result . | No. of results per 1000 patients tested (95% CI) . | No. of participants (studies) . | Certainty of the evidence (GRADE) . | |
|---|---|---|---|---|
| Prevalence 30%*†‡ in patients suspected of having PE . | Prevalence 40%†‡§ in patients suspected of having PE . | |||
| True positives | 291 (282-294) | 388 (376-392) | 992 (3) | ⨁⨁⨁◯ MODERATE|| |
| False negatives | 9 (6-18) | 12 (8-24) | ||
| True negatives | 700 (693-700) | 600 (594-600) | 992 (3) | ⨁⨁⨁◯ MODERATE|| |
| False positives | 0 (0-7) | 0 (0-6) | ||
| Inconclusive test results | 3 | 992 (3) | — | |
| Complications arising from the diagnostic test | Not reported | |||
Patient or population: patients with suspected recurrent PE. Setting: inpatient and outpatient. Pooled sensitivity: 0.97 (95% CI, 0.94-0.98). Pooled specificity: 1.00 (95% CI, 0.99-1.00). An interactive summary of findings is available at: https://gdt.gradepro.org/presentations/#/isof/isof_e7c58633-0d3e-4209-9a2f-5f072eaca759-1569995555070?_k=3k1k5o.
Data from Mos et al.78
†Data from Nijkeuter et al.79
Disease prevalence applies to the index test in each pathway. Prevalence applied to the accuracy of the subsequent tests depends on the result of the previous test in the pathway.
Data from Le Gal et al.77
Certainty of evidence was downgraded for imprecision given the small population size from the 3 recurrent PE study identified for analysis.