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Validation of the STA-Liatest DDi assay for exclusion of proximal deep vein thrombosis according to the latest Clinical and Laboratory Standards Institute/Food and Drug Administration guideline

Authors :
Carlos Aguilar
Andrew Rubin
Jeffrey A. Kline
Pascual Marco Vera
Colin G. Kaide
Gilles Pernod
John Lazarchick
Melhem J. Sharafuddin
Christopher Kabrhel
Suman M. Wasan
James Groce
Jeannine Kassis
Emmanuel de Maistre
Armando D'Angelo
D. Mark Courtney
Michelangelo Sartori
Source :
Blood Coagulation & Fibrinolysis
Publication Year :
2018
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2018.

Abstract

Recommended strategy for venous thromboembolism (VTE) diagnosis includes the use of sensitive D-dimer (DDi) assays along with pretest probability (PTP) assessment. The Clinical and Laboratory Standards Institute (CLSI) recently issued a guideline (US FDA endorsed) on DDi in VTE exclusion. Such guideline specifies the ideal D-dimer assay characteristics and target population. Demonstrate STA-LiatestD-Di performance combined with a PTP score for proximal deep vein thrombosis (pDVT) exclusion in a CLSI compliant study. International, multicenter, prospective nonrandomized, noninterventional clinical outcome management study conducted in a standard-of-care setting. DDi was measured in DVT-suspected consecutive low/moderate PTP outpatients, without conditions possibly impacting DDi values independently of thrombosis presence (age >80, pregnancy, postoperative, cancer) using a 0.5 μg/ml (FEU) threshold for DVT exclusion. Results were used to determine test performance. One thousand two hundred and thirty-four patients (17 centers) signed informed consent. Nine hundred and eighty (mean age: 55) with valid results (494 negative DDi) completed the study (DVT prevalence: 8.7%). STA-LiatestD-Di performance exceeded CLSI/FDA requirements: sensitivity: 100% (95% CI 95.8-100%), NPV: 100% (95% CI 99.3-100%). STA-LiatestD-Di associated with PTP score showed excellent performance for pDVT exclusion, as recently demonstrated for pulmonary embolism. The assay allows safe VTE exclusion, avoiding unnecessary imaging tests.

Details

ISSN :
09575235
Volume :
29
Database :
OpenAIRE
Journal :
Blood Coagulation & Fibrinolysis
Accession number :
edsair.doi.dedup.....d37c2a1e45b6e8101a2a777e441cff75
Full Text :
https://doi.org/10.1097/mbc.0000000000000750