Table 3.

Age-adjusted D-dimer test accuracy in a low-prevalence population

Test resultNo. of results per 1000 patients tested (95% CI)No. of participants (studies)Certainty of the evidence (GRADE)
Prevalence 5%* in patients with suspected PE
True positives 50 (49-50) 2885 (1) ⨁⨁⨁⨁ HIGH 
False negatives 0 (0-1) 
True negatives 446 (428-465) 2885 (1) ⨁⨁⨁⨁ HIGH 
False positives 504 (485-522) 
Inconclusive test results 2885 (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 5%* in patients with suspected PE
True positives 50 (49-50) 2885 (1) ⨁⨁⨁⨁ HIGH 
False negatives 0 (0-1) 
True negatives 446 (428-465) 2885 (1) ⨁⨁⨁⨁ HIGH 
False positives 504 (485-522) 
Inconclusive test results 2885 (1) — 
Complications arising from the diagnostic test Not reported 

Patient or population: patients with suspected PE. Setting: inpatient and outpatient. Pooled sensitivity: 0.99 (95% CI, 0.98-1.00). Pooled specificity: 0.47 (95% CI, 0.45-0.49). An interactive summary of findings is available at https://gdt.gradepro.org/presentations/#/isof/isof_a6f96835-4b9e-4342-b4ab-7dae1b5c9ead-1569977909216?_k=46z8fa.

*

Pooled prevalence of PE with low PTP in North American studies 6.5% (5% used in table).18 

Disease prevalence applies to the index test in each pathway. Prevalence applied to the accuracy of each subsequent test depends on the result of the previous test in the pathway.

Certainty of evidence not downgraded for imprecision given the large population size, though only 1 prospective age-adjusted D-dimer study was identified for analysis.

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