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A Diagnostic Strategy Involving a Quantitative Latex D-Dimer Assay Reliably Excludes Deep Venous Thrombosis

Shannon M. Bates, MDCM; Clive Kearon, MB, PhD; Mark Crowther, MD, MSc; Lori Linkins, MD; Martin O'Donnell, MB; Jim Douketis, MD; Agnes Y.Y. Lee, MD; Jeffrey I. Weitz, MD; Marilyn Johnston, ART; and Jeffrey S. Ginsberg, MD
[+] Article and Author Information

From McMaster University and Henderson Research Centre, Hamilton, Ontario, Canada.


Acknowledgments: The authors thank Jo-Ann Bennett, Sue Smale, Laurie Sardo, RN, Pam Stevens, RN, Terri Schnurr, RN, and Karen Woods, RN, for providing technological and nursing assistance and collecting the data and Sharon Hendershott for assisting in data management. They also thank Drs. Akbar Panju, Ameen Patel, and Stéphanie Cloutier for contributing patients.

Grant Support: By the Canadian Institutes of Health Research University–Industry (Organon Teknika Corp., now bioMérieux, Inc.) Program (grant UOP-42365). Dr. Bates is a recipient of a New Investigator Award from the Canadian Institutes of Health Research University–Industry (bioMérieux, Inc) Program. Drs. Kearon and Douketis are Research Scholars of the Heart and Stroke Foundation of Canada, and Dr. Crowther is a Research Scholar of the Medical Research Council of Canada. Dr. Linkins is a recipient of a Thrombosis Interest Group Research Fellowship. Dr. O'Donnell receives salary support from the Fraser Fellowship. Dr. Lee is a recipient of a New Investigator Award from the Canadian Institutes of Health Research/Rx & D Research Program. Drs. Weitz and Ginsberg are recipients of Career Investigator Awards from the Heart and Stroke Foundation of Ontario. Dr. Weitz also holds the Heart and Stroke Foundation of Ontario/J. Fraser Mustard chair in cardiovascular research and the Canada Research Chair in Thrombosis. Dr. Ginsberg is also a recipient of a Research Chair from the Canadian Institutes of Health Research.

Potential Financial Conflicts of Interest:Consultancies: J.S. Ginsberg (bioMérieux, Inc.); Honoraria: S.M. Bates (bioMérieux, Inc.); Grants received: S.M. Bates (Canadian Institutes of Health Research and bioMérieux, Inc.), C. Kearon (Canadian Institutes of Health Research and bioMérieux, Inc.), M. Crowther (Canadian Institutes of Health Research and bioMérieux, Inc.), J.S. Ginsberg (Canadian Institutes of Health Research and bioMérieux, Inc.).

Requests for Single Reprints: Shannon M. Bates, MDCM, McMaster University Medical Centre, HSC 3W11, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada; e-mail, batesm@mcmaster.ca.

Current Author Addresses: Drs. Bates and Ginsberg: McMaster University Medical Centre, HSC 3W11, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada.

Drs. Kearon and Lee: Hamilton Health Sciences—Henderson General Hospital, 711 Concession Street, Hamilton, Ontario L8V 1C3, Canada.

Drs. Crowther and Douketis: St. Joseph's Hospital, L208-4, 50 Charleton Avenue East, Hamilton, Ontario L8N 4A6, Canada.

Drs. Linkins, O'Donnell, and Weitz: Henderson Research Centre, 711 Concession Street, Hamilton, Ontario L8V 1C3, Canada.

Ms. Johnston: Hemostasis Reference Laboratory, 711 Concession Street, Hamilton, Ontario L8V 1C3, Canada.

Author Contributions: Conception and design: S.M. Bates, C. Kearon, M. Crowther, L. Linkins, M. O'Donnell, J. Douketis, A.Y.Y. Lee, J.I. Weitz, M. Johnston, J.S. Ginsberg.

Analysis and interpretation of the data: S.M. Bates, J.S. Ginsberg.

Drafting of the article: S.M. Bates, C. Kearon, M. Crowther, L. Linkins, M. O'Donnell, J. Douketis, A.Y.Y. Lee, J.I. Weitz, M. Johnston, J.S. Ginsberg.

Critical revision of the article for important intellectual content: S.M. Bates, C. Kearon, M. Crowther, L. Linkins, M. O'Donnell, J. Douketis, A.Y.Y. Lee, J.I. Weitz, M. Johnston, J.S. Ginsberg.

Final approval of the article: S.M. Bates, C. Kearon, M. Crowther, L. Linkins, M. O'Donnell, J. Douketis, A.Y.Y. Lee, J.I. Weitz, M. Johnston, J.S. Ginsberg.

Provision of study materials or patients: S.M. Bates, C. Kearon, M. Crowther, L. Linkins, M. O'Donnell, J. Douketis, A.Y.Y. Lee, J.I. Weitz, J.S. Ginsberg.

Statistical expertise: S.M. Bates, J.S. Ginsberg.

Obtaining of funding: S.M. Bates, C. Kearon, M. Crowther, J.S. Ginsberg.

Administrative, technical, or logistic support: S.M. Bates, J.I. Weitz, M. Johnston.

Collection and assembly of data: S.M. Bates, C. Kearon, M. Crowther, L. Linkins, M. O'Donnell, J. Douketis, A.Y.Y. Lee, M. Johnston, J.S. Ginsberg.


Ann Intern Med. 2003;138(10):787-794. doi:10.7326/0003-4819-138-10-200305200-00006
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This study was performed between August 1999 and November 2001 in three hospitals affiliated with McMaster University in Hamilton, Ontario, Canada (Hamilton Health Sciences—Henderson and McMaster University Divisions, and St. Joseph's Hospital). These hospitals serve the city of Hamilton (population, 460 000), as well as the more than 2 million residents of central western Ontario. Each center's research ethics board approved the study, and all patients provided written informed consent before enrollment.

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Summary for Patients

Negative Results on a Quantitative Latex D-Dimer Test Exclude Deep Leg Clots

The summary below is from the full report titled “A Diagnostic Strategy Involving a Quantitative Latex D-Dimer Assay Reliably Excludes Deep Venous Thrombosis.” It is in the 20 May 2003 issue of Annals of Internal Medicine (volume 138, pages 787-794). The authors are S.M. Bates, C. Kearon, M. Crowther, L. Linkins, M. O'Donnell, J. Douketis, A.Y.Y. Lee, J.I. Weitz, M. Johnston, and J.S. Ginsberg.

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