DAShED

The @dashedstudy team are in the process of preparing a grant application for a trial comparing strategies for investigating Acute Aortic Syndrome (AAS) in the ED. If you are a UK ED and interested in being a recruiting site, please email mattreed@ed.ac.uk for further information

High-sensitivity troponin has transformed MI detection, but front-door loading and unselective testing risk overdiagnosis & missed pathology. Our @EJ_EmergencyMed viewpoint article out today argues for reclaiming clinical reasoning in ED chest pain care journals.lww.com/euro-emergency…

🚨 Emergency Medicine Journal Club Acute Aortic Syndrome: Can decision rules help diagnosis? Join us for a discussion of the DAShED study, chaired by Prof. Gordon Fuller 🧠 🗓️ 30th Sept | 🕑 2–3pm 🔗 Register: us06web.zoom.us/webinar/regist…

Delighted our ASES study summary ‘Diagnostic strategies for suspected acute aortic syndrome; systematic review, meta-analysis, decision-analytic modelling & value of information analysis’ has been published in the @NIHRresearch HTA journal; download here: journalslibrary.nihr.ac.uk/hta/GGOP6363

Great to see @dashedstudy is the paper of choice for the next meeting of the new UK emergency medicine journal club on the 30th September at 2pm on Zoom, focussing around diagnostic approaches to acute aortic syndromes presenting to ED. Register here us06web.zoom.us/webinar/regist…

Case-control designs show high bias resulting in inaccurate estimates and lack of representativeness of test accuracy when applied in a clinical setting

Our ASES study also shows that diagnostic biomarkers for AAS, other than D-dimer, are not ready for routine clinical use. Large cohort studies are required to evaluate multiple biomarkers in an appropriate population with suspected AAS; emj.bmj.com/content/41/11/…

Primary research is required to evaluate this strategy in practice and determine how suspicion of AAS is identified

Our ASES decision analytical modelling of strategies for investigating suspected AAS shows that a strategy based on the Canadian clinical practice guideline using ADD-RS>1 or ADD-RS=1 with raised D-dimer to select patients for CTA appears cost-effective emj.bmj.com/content/early/…

I suggested a strategy based on D-Dimer & ADD-RS/Canadian will probably reduce the number of CTAs, be cost-effective & not lead to increased missed AAS but that a properly designed & funded implementation study is now required to provide clinicians with a safe effective strategy

What is the evidence around diagnosing Acute Aortic Dissection in the ED? At @EuropSocEM #eusem2024 I summarised the results of DAShED, ASES & PROFUNDUS. Here is a copy of my presentation; bit.ly/4f6Rr0l

Summary on aortic disection diagnostic by @HannahSchaubro1 #ESCGuidelines @escardio #ESCCongress 2024 #cvAcute

Catch up on the review of the @dashedstudy and get a sneak peek into DAShED2. Learn how this phase addresses what to do once #aorticdissection is considered but a CT scan isn't absolutely necessary. The recording is now available. #AortaEd aorticdissectioncharitabletrust.org/inside-look-at…

A great summary of the NIHR funded ASES study from Professor Steve Goodacre with insight from Valerie Lechene, an aortic dissection survivor who participated in the research

Professor Matt Reed talks through the DASHED 2 trial

#ResearchLetter #March2024 Survey of current policy regarding the recognition and management of acute aortic syndrome in Great Britain emj.bmj.com/content/41/3/1… @AorticDissectCT @mattreed73 @RCollEM @emerge_research

#OriginalResearch #March2024 Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the ED with symptoms consistent with acute aortic syndrome emj.bmj.com/content/41/3/1… @mattreed73 @emerge_research

@EMManchester @RCEMLearning @KirstyChallen @robertohle Link to the publication pubmed.ncbi.nlm.nih.gov/37945311/

Thank you @TheSGEM for choosing to cover @dashedstudy and for a very thorough and fair review

We definitely need to sort out the question of what you do once you ‘think aorta’ when the patient doesn’t absolutely need a scan (2.5% in DAShED) because we cannot CTA everyone - DAShED2 is in preparation and will attempt to answer this key clinical question