Diepveneuze trombose en longembolie uitsluiten met klinische beslisregels en D-dimeertesten

Conflict of interest: none declared. Financial support: I.C.M. Mos receives a grant from The Dutch Heart Foundation: grant number 2006B224. M. Tan receives a grant from the Dutch Heart Foundation: grant number 2007B146. Financial support for this article: none declared.

• Clinical diagnosis of a venous thromboembolism (VTE) is often difficult because the symptoms of this disorder are diverse and unspecified.

• The combination of a low probability clinical decision rule and an unremarkable D-dimer test is a safe way to exclude the presence of a VTE.

• Clinical decision rules for the diagnosis of a deep-vein thrombosis are available for primary and secondary care and clinical decision rules for the diagnosis of a pulmonary embolism is available for secondary care.

• Various D-dimer tests are available that differ with regard to sensitivity, specificity and duration of the measurement.

• During pregnancy and puerperium using a clinical decision rule and a D-dimer test is inadequate: additional radiologic investigation is always indicated in this situation.

• The diagnostic value of the D-dimer test during suspected recurrence of a VTE is yet to be determined.