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Clinical evaluation of eight different D-dimer tests for the exclusion of deep venous thrombosis in primary care patients

Type publicaties
Auteurs ROB F. M. OUDE ELFERINK 1,2 * , ANNEMARIEKE E. LOOT 1,2 * , CHANTAL G. J. VAN DE KLASHORST 1 , MARIEKE HULSEBOS-HUYGEN 1 , MARGRIET PIERSMA-WICHERS 3 & RUUD OUDEGA 4
Bron Scandinavian Journal of Clinical & Laboratory Investigation, 2015; Early Online: 1–9
Datum 2015 jan 20.
Onderwerpen

1 Certe – Department of Clinical Chemistry, Groningen, 2 Department of Clinical Chemistry, Martini Hospital, Groningen, 3 Certe – Department of Primary Care Diagnostics, Groningen, and 4 Julius Center for Health Sciences and Primary Care , University Medical Center Utrecht , Utrecht , the Netherlands

Abstract
D-dimer tests are an essential element in the diagnostic work-up of deep venous thrombosis (DVT). However, the poor standardization amongst assays necessitates clinical validation before implementation in daily practice. We therefore evaluated
the analytical and diagnostic performance of eight D-dimer tests in a representative group of 290 prospectively identified consecutive primary care patients with suspected DVT. Seven quantitative D-dimer assays, and a qualitative test,
Simplify, were evaluated. Correlation between assays was generally poor and several assays showed a signifi cant bias in the method comparison. Nevertheless, the Vidas D-dimer, Innovance D-dimer (CA1500 and BCS), Pathfast D-dimer, and
HemosIL HS500 (ACL TOP), all displayed 100% (95% CI: 85 – 100%) sensitivity. Tina-quant (Modular), AQT90 D-dimer, and Liatest (STA ® ) D-dimer tests showed a slightly lower sensitivity of 95% (78 – 100%). and the Simplify test reached a
sensitivity of 91% (72 – 99%) that was further improved in combination with a clinical decision rule to 95% (76 – 100%). In concert with the low (8.2%) prevalence of proximal DVT, diagnosed by compression ultrasonography, in our study, all
test reached a negative predictive value (NPV) of at least 99%. The user friendliness of the assays differed mainly by stability of reagents, calibration frequency, time required to obtain a test result and costs of a test. In conclusion, despite considerable
analytical differences, in our low-risk population all tests evaluated displayed an excellent NPV. In combination with a validated clinical decision rule to identify low-risk patients, even a straightforward POC solution could safely and cost-efficiently rule out DVT.

 

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Vibrio vulnificus outbreaks in Dutch eel farms since 1996: strain diversity and impact

Type publicaties
Auteurs O. L. M. Haenen, E. van Zanten, R. Jansen, I. Roozenburg, M. Y. Engelsma, A. Dijkstra, S. A. Boers, M. Voorbergen-Laarman, A. V. M. Möller
Bron Diseases of Aquatic Organisms
Datum 2014 apr 03.
Onderwerpen

Deze publicatie is op aanvraag verkrijgbaar bij het Secretariaat Medische Staf.

T 088 - 23 71 159
secretariaat@infectielab.nl

High Detection Rates of Enteropathogens in Asymptomatic Children Attending Day Care

Type publicaties
Auteurs Remko Enserink, Rianne Scholts (Certe), Patricia Bruijning-Verhagen, Erwin Duizer, Harry Vennema, Richard de Boer (Certe), Titia Kortbeek, Jeroen Roelfsema, Henriette Smit, Mirjam Kooistra-Smid (Certe), Wilfrid van Pelt
Bron http://www.plosone.org/
Datum 2014 feb 01.
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