Abstract
Acute aortic syndromes, including aortic dissection (AD), are rare. The AD detection risk score (ADDRS) and associated investigation pathway were developed to reduce missed diagnosis of AD. The methodology for its development was sub-optimal and it has not been robustly validated in the emergency department chest pain population. Recent research suggests that it will drive over-investigation and that the risks of missed diagnosis may not be in balance with the risks of the testing strategy. There are serious doubts about whether the score and investigation pathway are fit for purpose.
Highlights
Acute aortic syndromes, including aortic dissection (AD), are rare
The methodology for its development was sub-optimal and it has not been robustly validated in the emergency department chest pain population
High risk pain is defined as chest, back or abdominal pain that is either of abrupt onset or severe intensity or ripping/tearing in character
Summary
Acute aortic syndromes, including aortic dissection (AD), are rare. Presentation is variable and misdiagnosis is common [1]. The AD detection risk score (ADDRS) and associated investigation pathway were developed to reduce missed diagnosis of AD. Recent research suggests that it will drive over-investigation and that the risks of missed diagnosis may not be in balance with the risks of the testing strategy.
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