Herman M.A. Hofstee, MD
Potential Financial Conflicts of Interest: None disclosed.
Hofstee H.; Appropriateness of Excluding Pulmonary Embolism. Ann Intern Med. 2006;145:152. doi: 10.7326/0003-4819-145-2-200607180-00018
Download citation file:
Published: Ann Intern Med. 2006;145(2):152.
TO THE EDITOR:
I read the study by Roy and colleagues (1) with great interest. However, one thing puzzled me. In their Figure 2, the authors showed that pulmonary embolism (PE) had appropriately been ruled out when spiral computed tomography (CT) and enzyme-linked immunosorbent assay (ELISA) d-dimer results were negative in the low clinical probability group and that only a negative d-dimer result is sufficient to rule out PE in the high probability group. From basic epidemiology and studies concerning the value of d-dimer in the diagnosis of PE, we know that a negative d-dimer result provides high certainty for excluding PE (low post-test probability of PE). On the other hand, a negative d-dimer result in a group with a high a priori chance is insufficient to rule out PE (higher post-test probability of PE) (2). Could an error have occurred?
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only