Point-of-care testing for D-dimer in the exclusion of venous thromboembolism: A critical analysis
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Point-of-care testing (POCT) for D-dimer is an alternative to laboratory testing for the exclusion of venous thromboembolism (VTE). This critical review by the “extracorporeal circulation (ECC) and point-of-care testing” working group of the Société Française de Thrombose et d’Hémostase (French Society of Thrombosis and Hemostasis) aims to present the characteristics of six POCT D-dimer assays available in France in 2023. The article highlights the need to define VTE exclusion cutoffs specific to each technique and validated by clinical studies. There is insufficient data to validate the use of cutoffs suggested by manufacturers and age-adjusted thresholds. The article discusses the role of laboratories in justifying and prescribing POCT for D-dimer, according to objective criteria, such as the availability and turnaround time of classical laboratory tests. Rational prescribing should also be encouraged, limited to patients with a low risk of VTE, following an assessment of clinical probability according to national and international guidelines.
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