Key result
Clinical score plus D-dimer protocols achieve high sensitivity for acute aortic syndromes but vary in efficiency.
Why the study?
Protocols combining a clinical score with D-dimer have been developed to support diagnosis of acute aortic syndromes, but direct comparison of their diagnostic performance and cost-effectiveness is lacking.
What is the diagnostic performance and cost-effectiveness of protocols combining a clinical score with D-dimer for acute aortic syndromes?
Cohort
Yes
What is the diagnostic performance and cost-effectiveness of protocols combining a clinical score with D-dimer for acute aortic syndromes?
Guideline-compliant clinical score and D-dimer based protocols are highly sensitive for diagnosing acute aortic syndromes, though they vary in specificity and efficiency.
Supports ADD/DDage for efficient AAS rule-out with fewer CTAs; leaves open optimal protocol selection in prospective trials.
BACKGROUND: Acute aortic syndromes (AAS) are deadly conditions causing unspecific symptoms, such as chest/abdominal/back pain, syncope and neurological deficit. They are diagnosed with computed tomography angiography (CTA), but the patient selection is challenging. To support physicians and standardize management, protocols combining a clinical score with D-dimer (DD) have been developed. However, direct comparison of their diagnostic performance and cost-effectiveness is lacking. METHODS: ]). Costs were estimated using Italian and German reimbursements. RESULTS: . CONCLUSIONS: Guideline-compliant clinical score/DD based protocols are highly sensitive. Differences in specificity and efficiency are present. Data may guide decision-making based on policies and resources.
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Bima et al. (2025) conducted a cohort in Acute aortic syndromes (AAS). Clinical score with D-dimer (DD) protocols was evaluated on Diagnostic performance and cost-effectiveness. Guideline-compliant clinical score and D-dimer based protocols are highly sensitive for diagnosing acute aortic syndromes, though differences in specificity and efficiency exist.
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