American College of Physicians

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Released April 4, 2012

In patients with low pretest probability of venous thromboembolism (VTE), obtain a high-sensitive D-dimer measurement as the initial diagnostic test; don’t obtain imaging studies as the initial diagnostic test.

In patients with low pretest probability of VTE as defined by the Wells prediction rules, a negative high-sensitivity D-dimer measurement effectively excludes VTE and the need for further imaging studies.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.


2011 ACEP pulmonary embolism guideline; 2008 ESC pulmonary embolism guideline; 2007 AAFP/ACP venous thromboembolism guideline; 2010 SIGN venous thromboembolism guideline.