Table 8.

D-dimer for recurrent PE sensitivity and specificity

Test resultNo. of results per 1000 patients tested (95% CI)No. of participants (studies)Certainty of the evidence (GRADE)
Prevalence 30%* in patients suspected of having PEPrevalence 40%§ in patients suspected of having PE
True positives 300 (291-300) 400 (388-400) 304 (1) ⨁⨁◯◯ LOW|| 
False negatives 0 (0-9) 0 (0-12) 
True negatives 189 (147-238) 162 (126-204) 304 (1) ⨁⨁◯◯ LOW|| 
False positives 511 (462-553) 438 (396-474) 
Inconclusive test results 304 (1)  
Complications arising from the diagnostic test Not reported 
Test resultNo. of results per 1000 patients tested (95% CI)No. of participants (studies)Certainty of the evidence (GRADE)
Prevalence 30%* in patients suspected of having PEPrevalence 40%§ in patients suspected of having PE
True positives 300 (291-300) 400 (388-400) 304 (1) ⨁⨁◯◯ LOW|| 
False negatives 0 (0-9) 0 (0-12) 
True negatives 189 (147-238) 162 (126-204) 304 (1) ⨁⨁◯◯ LOW|| 
False positives 511 (462-553) 438 (396-474) 
Inconclusive test results 304 (1)  
Complications arising from the diagnostic test Not reported 

Patient or population: patients with suspected recurrent pulmonary embolism. Setting: inpatient and outpatient. Pooled sensitivity: 1.00 (95% CI, 0.97-1.00). Pooled specificity: 0.27 (95% CI, 0.21-0.34). An interactive summary of findings is available at: https://gdt.gradepro.org/presentations/#/isof/isof_16692888-165a-4eaa-ac25-6823e63d0aff-1569995266014?_k=4hew36.

*

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 1 recurrent PE study identified for analysis.

Certainty of evidence was downgraded for risk of bias from a secondary analysis of 2 prospective multicenter studies with a mixed population of recurrent and first-time PE patients.

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