Aortic dissection detection risk score has high sensitivity with moderate inter‐rater reliability

Rotella, Joe‐Anthony; Goel, Vishal; Chan, Thomas; Yeoh, Michael; Taylor, David

doi:10.1111/1742-6723.13152

Cited by 7 publications

(6 citation statements)

References 4 publications

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“…Finally, we included nine studies in this review ( Figure 1). [6][7][8][9][22][23][24][25][26] Supplementary Table 2 shows the characteristics of the included studies.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

“…Figure 2 shows the results of the quality assessment of the seven included studies. Four studies 6,23,24,26 were assessed as having high risk of bias in patient selection because, among suspected AAS patients, one study included only patients who underwent D-dimer, 6 whereas other studies included only patients who underwent CT. 23,24,26 Four studies 6,9,25,26 had at least one unclear risk of bias in the domain of index test (ADD-RS alone or with D-dimer) or the reference standard because there was no clear statement that the index test was independently interpreted without knowledge of the result of the reference standard or vice versa. One study 9 had an unclear risk of bias in flow and timing because ADD-RS was retrospectively assessed based on the prehospital condition of patients and there was no clear indication of the interval between ADD-RS and aortic imaging.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

“…Most included studies were European or Asian. Eight studies were retrospective studies 6,7,9,22–26 and one 9 was conducted in a prehospital setting. The sample sizes ranged from 162 to 22,075.…”

Section: Resultsmentioning

confidence: 99%

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Accuracy of aortic dissection detection risk score alone or with D-dimer: A systematic review and meta-analysis

Tsutsumi

Tsujimoto

Takahashi

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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Background: To evaluate the diagnostic accuracy and clinical utility of the acute aortic dissection detection risk score (ADD-RS) alone or with D-dimer as a screening test to exclude acute aortic syndrome. Methods: We conducted a systematic review and meta-analysis of studies examining the diagnostic accuracy of ADD-RS. We searched MEDLINE, Embase and Cochrane Controlled Register of Trials up to 12 December 2018. Results: We identified nine studies involving 26,598 patients for ADD-RS alone and 3421 patients with D-dimer. Overall, the methodological quality based on the Quality Assessment of Diagnostic Accuracy Studies 2 was moderate to high. Bivariate meta-analyses showed that the pooled sensitivities were 0.94 (95% confidence interval (CI) 0.90, 0.96) at the threshold of ADD-RS ≥1, 0.46 (95% CI, 0.34, 0.59) at ADD-RS ≥2, 1.00 (95% CI 0.99, 1.00) at ADD-RS ≥1 with D-dimer and 0.99 (95% CI 0.97, 1.00) at ADD-RS ≥2 with D-dimer. For the low prevalence population, failure rate and efficiency were 0.8% and 38.3% at ADD-RS ≥1, 0.03% and 14.5% at ADD-RS ≥1 with D-dimer, and 0.1% and 33.6% at ADD-RS ≥2 with D-dimer, respectively. For the high prevalence population, failure rate and efficiency were 3.8% and 33.3% at ADD-RS ≥1, 0.2% and 12.3% at ADD-RS ≥1 with D-dimer and 0.6% and 28.4% at ADD-RS ≥2 with D-dimer, respectively. Conclusions: ADD-RS alone or with D-dimer was a useful screening test with high sensitivity to exclude acute aortic syndrome. However, the optimal threshold of ADD-RS alone or with D-dimer may depend on the clinical setting.

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“…Finally, we included nine studies in this review ( Figure 1). [6][7][8][9][22][23][24][25][26] Supplementary Table 2 shows the characteristics of the included studies.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

Section: Results Of the Literature Searchmentioning

confidence: 99%

See 1 more Smart Citation

Accuracy of aortic dissection detection risk score alone or with D-dimer: A systematic review and meta-analysis

Tsutsumi

Tsujimoto

Takahashi

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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“…The design and patient characteristics of the 13 included studies [18][19][20][21][22][23][24][25][26][27][28][29][30] are summarised in Table 1. We report the characteristics of the whole study cohort in this table.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Diagnostic accuracy of the aortic dissection detection risk score alone or with D-dimer for acute aortic syndromes: Systematic review and meta-analysis

Ren,

Essat,

Pandor

et al. 2024

PLoS ONE

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Objectives To evaluate the diagnostic accuracy of the aortic dissection detection risk score (ADD-RS) used alone or in combination with D-dimer for detecting acute aortic syndrome (AAS) in patients presenting with symptoms suggestive of AAS. Methods We searched MEDLINE, EMBASE, and the Cochrane Library from inception to February 2024. Additionally, the reference lists of included studies and other systematic reviews were thoroughly searched. All diagnostic accuracy studies that assessed the use of ADD-RS alone or with D-Dimer for diagnosing AAS compared with a reference standard test (e.g. computer tomographic angiography (CTA), ECG-gated CTA, echocardiography, magnetic resonance angiography, operation, or autopsy) were included. Two reviewers independently selected and extracted data. Risk of bias was appraised using QUADAS-2 tool. Data were synthesised using hierarchical meta-analysis models. Results We selected 13 studies from the 2017 citations identified, including six studies evaluating combinations of ADD-RS alongside D-dimer>500ng/L. Summary sensitivities and specificities (95% credible interval) were: ADD-RS>0 94.6% (90%, 97.5%) and 34.7% (20.7%, 51.2%), ADD-RS>1 43.4% (31.2%, 57.1%) and 89.3% (80.4%, 94.8%); ADD RS>0 or D-Dimer>500ng/L 99.8% (98.7%, 100%) and 21.8% (12.1%, 32.6%); ADD RS>1 or D-Dimer>500ng/L 98.3% (94.9%, 99.5%) and 51.4% (38.7%, 64.1%); ADD RS>1 or ADD RS = 1 with D-dimer>500ng/L 93.1% (87.1%, 96.3%) and 67.1% (54.4%, 77.7%). Conclusions Combinations of ADD-RS and D-dimer can be used to select patients with suspected AAS for imaging with a range of trade-offs between sensitivity (93.1% to 99.8%) and specificity (21.8% to 67.1%).

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“…Two well-known tools for rapid prediction of AAS are the aortic dissection detection risk score (ADD-RS) and D-dimer (DD) [ [6] , [7] , [8] , [9] , [10] ]. ADD-RS is a pre-test tool that classifies the patients in 3 (ADD-RS = 0, ADD-RS = 1, ADD-RS>1) or 2 (ADD-RS≤1, ADD-RS>1) categories [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Predicting acute aortic syndrome using aortic dissection detection risk score, D-dimer, and X-ray

Song,

Choi,

Lee

2023

Heliyon

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Aortic dissection detection risk score has high sensitivity with moderate inter‐rater reliability

Abstract: The ADD-RS was highly sensitive in our cohort. Further work to evaluate the score prospectively and in combination with a D-Dimer is required.

Cited by 7 publications

References 4 publications

Accuracy of aortic dissection detection risk score alone or with D-dimer: A systematic review and meta-analysis

Accuracy of aortic dissection detection risk score alone or with D-dimer: A systematic review and meta-analysis

Diagnostic accuracy of the aortic dissection detection risk score alone or with D-dimer for acute aortic syndromes: Systematic review and meta-analysis

Predicting acute aortic syndrome using aortic dissection detection risk score, D-dimer, and X-ray

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