Potential impact of adjusting the threshold of the quantitative D-dimer based on pretest probability of acute pulmonary embolism.

Objectives: The utility of D-dimer testing for suspected pulmonary embolism (PE) can be limited by test specificity. The authors tested if the threshold of the quantitative D-dimer can be varied according to pretest probability (PTP) of PE to increase specificity while maintaining a negative predictive value (NPV) of >99%.

Methods: This was a prospective, observational multicenter study of emergency department (ED) patients in the United States.