{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:27:20Z","timestamp":1793122040643,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"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":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>An aortic dissection (AoD) is a potentially life\u2010threatening emergency with mortality rates exceeding 50%. While computed tomography angiography remains the diagnostic standard, patients may be too unstable to leave the emergency department. Investigators developed a point\u2010of\u2010care ultrasound (POCUS) protocol combining transthoracic echocardiography (TTE) and the abdominal aorta. The study objective was to determine the test characteristics of this protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an institutional review board\u2013approved, multicenter, prospective, observational, cohort study of a convenience sample of adult patients. Patients suspected of having an AoD received a TTE and abdominal aorta POCUS. Three sonographic signs suggested AoD: a pericardial effusion, an intimal flap, or an aortic outflow track diameter measuring more than 35\u2009mm. Investigators present continuous and categorical data as medians with interquartile ranges or proportions with 95% confidence intervals (CIs) and utilized standard 2\u2009\u00d7\u20092 tables on MedCalc (Version 19.1.6) to calculate test characteristics with 95% CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Investigators performed 1314 POCUS examinations, diagnosing 21 Stanford type A and 23 Stanford type B AoD. Forty\u2010one of the 44 cases had at least one of the aforementioned sonographic findings. The protocol has a sensitivity of 93.2% (95% CI 81.3\u201398.6), specificity of 90.9 (95% CI 89.2\u201392.5), positive and negative predictive values of 26.3% (95% CI 19.6\u201333.9) and 99.7% (95% CI 99.2\u2013100), respectively, and an accuracy of 91% (95% CI 89.3\u201392.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SPEED protocol has an overall sensitivity of 93.2% for AoD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.14839","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T19:39:57Z","timestamp":1701113997000},"page":"112-118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The sonographic protocol for the emergent evaluation of aortic dissections (\n                    <scp>SPEED<\/scp>\n                    protocol): A multicenter, prospective, observational study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1686-8771","authenticated-orcid":false,"given":"Ryan C.","family":"Gibbons","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Lewis Katz School of Medicine at Temple University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Winchester Medical Center  Winchester Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rivka","family":"Feig","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Geisinger Commonwealth School of Medicine  Lewistown Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Mulflur","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Saint Luke's Hospital  Easton Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"Costantino","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Lewis Katz School of Medicine at Temple University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu281"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.029"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2011.07.008"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2011.11.017"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.10.055"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.534198"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.5811\/cpcem.2018.6.38106"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2006.07.020"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.7.897"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(00)90047-0"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.988568"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872614527010"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.833004"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.04.257"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872615594497"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.02.42"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.11.002"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-014-1080-9"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2015.12.005"},{"key":"e_1_2_9_21_1","unstructured":"STROBE: Strengthening the reporting of observational studies in epidemiology. 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