The cost-effectiveness of point-of-care D-dimer tests compared with a laboratory test to rule out deep venous thrombosis in primary care

Expert Rev Mol Diagn. 2015 Jan;15(1):125-36. doi: 10.1586/14737159.2015.976202.


Objective: Point-of-care (POC) D-dimer tests have been developed to exclude deep venous thrombosis quickly and on the spot, but are known to have lower sensitivity compared with laboratory-based tests. Their cost-effectiveness is still unknown.

Methods: We updated and extended a previously published Markov model to assess the cost-effectiveness of POC D-dimer tests ('Simplify', 'Cardiac', 'Triage' and 'Nycocard') compared with a laboratory-based latex assay to diagnose deep venous thrombosis in primary care.

Results: The 'Laboratory' strategy resulted in 6.986 quality-adjusted life years at the cost of €8354 per patient. All POC D-dimer tests resulted in health outcomes similar to the 'Laboratory' strategy. The 'Simplify' strategy maximized cost savings (-€155 [95% CI: -€246 to -€83]).

Conclusions: POC D-dimer tests yield similar health outcomes as laboratory-based testing procedures but can be performed more easily and at lower costs. Therefore, these tests are an alternative to laboratory-based testing and might be considered for exclusion of deep venous thrombosis in primary care.

Keywords: D-dimer; cost–effectiveness; point-of-care test; primary care; venous thromboembolism.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • Point-of-Care Systems / economics*
  • Primary Health Care
  • Venous Thrombosis / blood
  • Venous Thrombosis / diagnosis*


  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D