Primary survey: highlights from this issue

Many medical journals run themed issues where authors are invited to submit articles, usually around a specific clinical condition, and coordinated by guest editors.We have long debated whether we should take this approach at the Emergency Medicine Journal.Perhaps the sheer variety of conditions we see on a dayto-day basis in emergency medicine means that a broader approach to publication of our monthly issues should be maintained.However, this month, our authors have done the hard work for us with four original manuscripts and an accompanying commentary around the specific condition of acute aortic syndromes (AAS).An informal themed issue.Many readers will be familiar with this month's Editor's Choice, the Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: a triumph in research delivery.This prospective study recruited >5000 participants in just a 40-day window across 27 UK EDs.The striking findings demonstrate the low prevalence of AAS and the low pick-up rate of current diagnostic strategiesunder 3% of CT aortograms performed were positive.Sadly, none of the decision rules they examined performed adequately as rule-out strategies.The excellent accompanying commentary by Peter Jones, appropriately entitled 'Finding the needle in the haystack', discusses both the research delivery and clinical implications of this work in more detail, with the suggestion that more research is needed.DAShED provides a focus on where that research should be targeted.Jones' commentary also discusses the survey of current practice in AAS diagnostics and management published as a research letter by members of the DAShED group and the Aortic Dissection Charitable Trust (who developed the prominent Think Aorta Campaign).This survey highlights that a more unified approach to diagnosis and management is needed.However, with