{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:48:51Z","timestamp":1787060931137,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,6]],"date-time":"2022-11-06T00:00:00Z","timestamp":1667692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Aortic dissection (AD) is rare. Missed AD is a common reason for coronial investigations and civil claims for medical negligence. Recommendations include improved education, supervision and information transfer, reminders in chest pain pathways and higher rates of investigation for AD. Higher investigation rates pose risks to patients and the health system which may not be in balance with the likelihood of AD. The appropriate diagnostic yield of investigation to balance risk and benefit has not been defined. The AD detection risk score pathway has been proposed as a useful diagnostic tool but concerns about its derivation, validation and utility remain. In this paper, we try to draw together published literature and local audit data to develop recommendations about what might be done to reduce the number of missed AD cases in EDs and what the impact of higher investigation rates might be.<\/jats:p>","DOI":"10.1111\/1742-6723.14127","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T02:39:27Z","timestamp":1667788767000},"page":"176-180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["What can be done to improve diagnosis of aortic dissection?"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4655-5023","authenticated-orcid":false,"given":"Anne\u2010Maree","family":"Kelly","sequence":"first","affiliation":[{"name":"Joseph Epstein Centre for Emergency Medicine Research, Western Health Sunshine Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine \u2013 Western Health, Melbourne Medical School The University of Melbourne  Melbourne Victoria Australia"},{"name":"Australian Centre for Health Law Research Queensland University of Technology  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu Qing","family":"Lee","sequence":"additional","affiliation":[{"name":"Footscray Hospital Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Curran","sequence":"additional","affiliation":[{"name":"Sunshine Hospital Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja14.00165"},{"key":"e_1_2_10_3_1","unstructured":"Inquest into the death of Neville Ernest Mills COR 2021 003764 (Victoria)."},{"key":"e_1_2_10_4_1","unstructured":"Vicki Boxell & Ors v Peninsula Health [2019] VSC 830."},{"key":"e_1_2_10_5_1","unstructured":"Medical Negligence FAQs: Your 10 Most Common Questions Answered. [Cited 12 Oct 2022.] Available from URL:https:\/\/medical-law.com.au\/medical-negligence-faqs-your-10-most-common-questions-answered"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13472"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-64299-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.988568"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2015.6.25752"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12916"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13634"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2013.06.005"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.031264"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181d4739e"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029457"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(99)70309-4"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.37349\/emed.2021.00053"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2007.01388.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13603"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.427"},{"key":"e_1_2_10_21_1","first-page":"HS\u201014","article-title":"Intravenous radiocontrast media: a review of allergic reactions","volume":"37","author":"Saljoughian M","year":"2012","journal-title":"US Pharm."},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12912"},{"key":"e_1_2_10_23_1","unstructured":"Monash University.Improving Medical Diagnosis. [Cited 5 Oct 2022.] Available from URL:https:\/\/www.behaviourworksaustralia.org\/major-project\/vmia-trial-1-improving-medical-diagnosis"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.14127","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1742-6723.14127","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.14127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T20:53:07Z","timestamp":1692478387000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.14127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,6]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1111\/1742-6723.14127"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.14127","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,6]]},"assertion":[{"value":"2022-10-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}