{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T17:13:22Z","timestamp":1789233202866,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>D\u2010dimers are produced by lysis of cross\u2010linked fibrin. In children, D\u2010dimer testing is used to evaluate disseminated intravascular coagulation (DIC) and some inflammatory states, but its use is not validated for screening or ruling out suspected venous thromboembolic events (VTE). In adults, D\u2010dimers are used to evaluate DIC, and a low D\u2010dimer level is used to exclude VTE in patients when combined with a low or moderate probability of VTE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To assess D\u2010dimer utilization and opportunities for improvement, we conducted a retrospective, consecutive\u2010case cohort study (with ethics approval) of patients who had D\u2010dimer tests at Hamilton hospitals, from 06\/2022 to 05\/2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>D\u2010dimer levels were evaluated for 175 children and 200 adults (respective results, children\/adults: median ages: 12\/63, ranges 0\u201317\/18\u201394\u2009years), and an overlapping cohort of 99 consecutive persons with \u2265\u20095 D\u2010dimer determinations. Most patients had D\u2010dimer tests in emergency departments (60%\/62%) and elevated D\u2010dimer levels (55%\/61%). Reasons for D\u2010dimer assessment included: suspected VTE (50%\/70%), DIC (17%\/3.5%), childhood inflammatory conditions (23%\/0%), and \u201coff\u2010label\u201d uses (e.g., arterial thrombosis assessment; 5%\/22%). VTE likelihood and DIC scores were rarely documented. Patients with multiple tests accounted for 15% of D\u2010dimer workload. Among patients with multiple tests for DIC, most had overt DIC on initial assessment, with declining D\u2010dimer levels over 10\u201314\u2009days, including patients who died.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VTE and DIC assessment was the most common reason for D\u2010dimer assessments for children and adults. Quality improvement initiatives are needed to improve relevant clinical VTE and DIC score documentation and D\u2010dimer test utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70024","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T11:56:22Z","timestamp":1763121382000},"page":"392-401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Retrospective Study of Adult and Pediatric D\u2010Dimer Tests to Identify Opportunities for Improved Utilization"],"prefix":"10.1111","volume":"48","author":[{"given":"Rabab","family":"Al Dawood","sequence":"first","affiliation":[{"name":"Department of Pathology and Molecular Medicine McMaster University  Hamilton Canada"},{"name":"Department of Pathology and Laboratory Medicine King Fahad Specialist Hospital  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan Abu","family":"Sabah","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine McMaster University  Hamilton Canada"},{"name":"Department of Pathology and Laboratory Medicine King Faisal Medical City for Southern Regions  Abha Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Mathews","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine McMaster University  Hamilton Canada"},{"name":"Hematology\/Oncology, Centre Hospitalier Universitaire Sainte\u2010Justine  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Douketis","sequence":"additional","affiliation":[{"name":"Department of Medicine McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2843-0817","authenticated-orcid":false,"given":"Catherine","family":"Hayward","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine McMaster University  Hamilton Canada"},{"name":"Department of Medicine McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","first-page":"9","article-title":"Age Dependency for Coagulation Parameters in Paediatric Populations. 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