Paperchase 3 - Scanning Everything and Proud!

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Christopher J. -

Love the section, but would politely disagree with the idea that D-Dimer should be used in only low risk patients. This is a dogma that has been passed on and really only encourages people to use D-Dimer in "no-risk" patients. Many PE experts feel it can be applied to low or moderate risk patients. This idea was validated in a study titled "Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography."JAMA. 2006 Jan 11;295(2):172-9. If there is a negative Ddimer in a patient with less than or equal to 4 Wells criteria risk of PE was about .4%, none of them fatal. Use the Ddimer more to help us reduce CT's. Recurrent emphasis of this dogma makes people do more CT's.


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