At the congress of the International Society on Thrombosis and Haemostasis, dr. Rita Selby gave a state-of-the-art lecture, entitled: D-dimer Diagnostics: Can I use any D-dimer assay? Bridging the Knowledge-to-Action gap. This lecture has been further elaborated in a state-of-the-art publication.
Abstract
A State of the Art lecture titled “D-dimer Diagnostics: Can I use any D-dimer assay? Bridging the Knowledge-to-Action gap” was presented at the International Society on Thrombosis and Haemostasis Congress in 2023, included in the session on the clinical impact of variability in commonly used coagulation assays. Here, we review the role of Ddimer, primarily in the outpatient diagnosis of patients with venous thromboembolism (VTE) when combined with clinical decision rules. We focus on the recent large management trials that have studied adjustments of VTE exclusion thresholds for D-dimer based on either prior clinical probability of VTEor patient age, and the resultant benefitof reduced imaging for VTE and improved diagnostic efficiency. In this context, we report on the significant variability between D-dimer results and the multiple D-dimer assays in use worldwide using data from international external quality assurance programs. This variability is particularly high at typical VTE exclusion thresholds. We discuss the potential clinical impact of D-dimer assay substitution on accuracy of diagnosis and risk stratification of patients with VTE. Finally, we summarize relevant new data on this topic presented during the 2023 International Society on Thrombosis and Haemostasis Congress and outline future priorities urgently needed to harmonize D-dimer results and reporting that will require international collaboration among multiple stakeholders with an overall goal to close this knowledge-to-action gap.
Res Pract Thromb Haemost, 2024; 8: 102335.
This publication can be approached via the following link: D-dimer diagnostics: can I use any D-dimer assay? Bridging the knowledge-to-action gap – Research and Practice in Thrombosis and Haemostasis (rpthjournal.org)