Appendices
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Question 1 of 1
1. Question
Appendix 1:
Diagnosing Aortic Dissection
Aortic Dissection Detection Risk Score26
ADD-RS>1 Sensitivity: 0.94
Specificity: 0.40
–ve LR 0.16
ADD-RS>2 Sensitivity: 0.46
Specificity: 0.91
–ve LR 0.59
ADD-RS >1 / +ve D-dimer Sensitivity: 1.00
Specificity: 0.15
–ve LR 0.01
The addition of D-dimer to this rule increases sensitivity whilst decreasing specificity. As discussed during discussion of ROC curves, this is often a trade-off that requires careful thought when creating a CDR. Clinicians should consider the potential increase in testing if this were indiscriminately used and ensure that it is applied appropriately to patients with a higher pre-test probability of aortic dissection.26,27 Campaigns such as the Think Aorta campaign28 seem to be changing the conversation around ease of obtaining CT imaging of the aorta, although I must confess I have no data for this!
