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The authors must be commended on their elaborate effort to prove the futility of D-dimer testing in postoperative patients. Innumerable studies have been done to try and prove the usefulness of D-dimer testing along with pre-test probability score, all aimed at avoiding expensive imaging.1–3 The study could have been more meaningful if they had clarified the following issues:
D-Dimer should remain as a screening test for proximal DVT and pulmonary embolism for out-patients with low clinical probability of DVT, where it obviates the need for a duplex ultrasound examination. Positive D-dimer, irrespective of its value, has little meaning when the probability of clinical DVT is high.