Exploring Patterns of D-Dimer Assay Ordering at an Australian Rural Referral Hospital: A Retrospective Audit.
To explore patterns of D-dimer assay ordering for the diagnosis of pulmonary embolism (PE) and evaluate its clinical usefulness at Dubbo Health Service.
Retrospective audit of patients presenting to Dubbo Health Service between 1 January and 31 December 2024 who underwent D-dimer testing. D-dimer and CTPA ordering patterns were categorised according to their alignment with the guideline-recommended investigation sequence, which informed interpretation of test utilisation in the clinical context.
A total of 245 D-dimer results were included (119 positive, 126 negative). In 79.2% of cases, investigation sequences followed the guideline-recommended order of testing. The diagnostic yield of CTPA among patients who underwent D-dimer testing was 4.9%.
Ordering patterns were broadly consistent with published reports of increasing utilisation of D-dimer testing and CTPA. Discordant pathways most commonly involved positive D-dimer results without subsequent CTPA, or CTPA performed despite a negative D-dimer.
Patterns of D-dimer ordering were variably aligned with guideline-recommended pathways, which may limit the clinical usefulness of the test in some cases. Improved documentation of pre-test probability and targeted education regarding appropriate test selection and interpretation may enhance the integration of D-dimer testing into diagnostic workflows.
Retrospective audit of patients presenting to Dubbo Health Service between 1 January and 31 December 2024 who underwent D-dimer testing. D-dimer and CTPA ordering patterns were categorised according to their alignment with the guideline-recommended investigation sequence, which informed interpretation of test utilisation in the clinical context.
A total of 245 D-dimer results were included (119 positive, 126 negative). In 79.2% of cases, investigation sequences followed the guideline-recommended order of testing. The diagnostic yield of CTPA among patients who underwent D-dimer testing was 4.9%.
Ordering patterns were broadly consistent with published reports of increasing utilisation of D-dimer testing and CTPA. Discordant pathways most commonly involved positive D-dimer results without subsequent CTPA, or CTPA performed despite a negative D-dimer.
Patterns of D-dimer ordering were variably aligned with guideline-recommended pathways, which may limit the clinical usefulness of the test in some cases. Improved documentation of pre-test probability and targeted education regarding appropriate test selection and interpretation may enhance the integration of D-dimer testing into diagnostic workflows.