D-Dimer only testing for PE

Here is a common scenario: The resident presents a case of a 58 yo patient who has presented with shortness of breath. They go over the examination, the ECG findings and then say ".... and the D-Dimer was...." Your next question may be, "Why did you do a D-dimer? Were you suspicious for a pulmonary embolism(PE)? What's the Well's Score, what's your pretest probability?........" 

Does just doing a D-dimer on its own help make or exclude the diagnosis and does it result in less imaging?

This study(1) looked at a D-Dimer-only pathway (ie., no clinical prediction rules), with the objective of reducing the number of patients receiving imaging.

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