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Emerg Med J 2004;21:663-666 doi:10.1136/emj.2003.011049
  • Original Article

Evaluation of the Simplify d-dimer assay as a screening test for the diagnosis of deep vein thrombosis in an emergency department

  1. D Neale1,
  2. C Tovey2,
  3. A Vali3,
  4. S Davies1,
  5. K Myers1,
  6. M Obiako2,
  7. V Ramkumar2,
  8. A Hafiz2
  1. 1Haematology Department, Prince Charles Hospital, Merthyr Tydfil, Mid Glamorgan, Wales
  2. 2Emergency Department, Prince Charles Hospital
  3. 3Radiology Department, Prince Charles Hospital
  1. Correspondence to:
 Mr C Tovey
 Emergency Department, Prince Charles Hospital, Merthyr Tydfil, Mid Glamorgan, Wales CF47 9DT, UK; clive.toveynglam-tr.wales.nhs.uk
  • Accepted 5 February 2004

Abstract

Objectives: To evaluate the use in an emergency department of a new d-dimer assay (Simplify d-dimer) as a screening test for deep vein thrombosis (DVT).

Methods: 187 outpatients with clinical features suspicious of acute DVT were entered into this study. A Simplify d-dimer test was performed in the emergency department on all patients. A SimpliRED d-dimer test and a semi-automated latex agglutination assay (Auto-d-dimer 700 on a Thromboscreen 400C analyser) were performed in the haematology laboratory. All patients were investigated with contrast venography to confirm or exclude the diagnosis of DVT.

Results: The Simplify test had a sensitivity of 94.1% and a negative predictive value (NPV) of 94.8%. These results compared favourably with the SimpliRED test (sensitivity 74.5%, NPV 89.7%) and the latex agglutination assay (sensitivity 90.2%, NPV 92.2%). This increased sensitivity was at the cost of a lower specificity, the specificity of the three d-dimer tests being Simplify 40.4%, SimpliRED 83.1%, and latex agglutination 43.4%.

Conclusions: Simplify proved to be a rapid and easy to use test and may be useful for use in the emergency department as part of a diagnostic algorithm for deep vein thrombosis. Further larger scale studies are needed.

Footnotes

  • Funding: none.

  • Competing interests: none declared.

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