A message from “Dchrist” at Mercy Hospital in Chicago:
What is the clinical rationale, if any, for offering both a qualitative and quantitative D-dimer assay in the main hospital lab?
Hello, and thank you for your question. It may be that your director retains the qualitativeassay for a quick turn-around to help diagnose disseminated intravascular coagulation (DIC), in which D-dimer levels become markedly elevated. The quantitative assay, which is also speedy and could be used for both applications, is primarily used to rule outvenous thromboembolism in symptomatic patients who have a low pre-assay clinical score for thrombosis. Here is a small study comparing qualitative and quantitative point-of-care D-dimer assays in thromboembolism: Geersing GJ, Janssen KJ, Oudega R, et al. Excluding venous thromboembolism using point of care D-dimer tests in outpatients: a diagnostic meta-analysis. BMJ 2009; 339:b2990. doi: 10.1136/bmj.b2990.