{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:57:25Z","timestamp":1767193045836,"version":"3.48.0"},"reference-count":26,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T00:00:00Z","timestamp":1754697600000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004690","name":"Minist\u00e8re de la Sant\u00e9","doi-asserted-by":"publisher","award":["Interregional Program for Clinical Research in Hos"],"award-info":[{"award-number":["Interregional Program for Clinical Research in Hos"]}],"id":[{"id":"10.13039\/501100004690","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,17]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dyspnoea frequently leads to admissions in the Emergency Department (ED). Rapid and accurate diagnosis, specifically to distinguish acute heart failure from pneumonia and exacerbations of chronic obstructive pulmonary disease (COPD), is imperative to initiate appropriate therapy. This study aims to evaluate the feasibility and performance of the EMERgency ALgorithm efficiency for Dyspneic patient-UltraSound (EMERALD-US) algorithm using ultrasound (US) to diagnose the etiology of dyspnea in the ED-admitted patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method and analysis<\/jats:title>\n                    <jats:p>225 patients of 50 years and above, presenting with acute non-traumatic dyspnoea, across six participating EDs will be enrolled. Patients will undergo a lung, a simplified four-chamber cardiac and a venous US. A physician, blinded to any clinical data or previous results, will execute the algorithm. The algorithm\u2019s performance will be assessed using a receiver operating characteristic (ROC) curve. Secondary objectives include an evaluation of the protocol\u2019s feasibility in the ED, an assessment of the concordance between the EMERALD-US algorithm diagnoses and results from other diagnostic tests (including laboratory work and imaging), as well as an evaluation of the algorithm\u2019s performance in diagnosing other causes of dyspnoea, such as pulmonary embolism or pleural effusion, and the 30-day mortality rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study protocol was approved by the French Committee for the Protection of Persons (CPP) (RCB n\u00b02018-A02136-49). Misdiagnosis of dyspneic patients on ED admission has been associated with inappropriate treatment, prolonged hospital stays and increased mortality, particularly among elderly patients. The implementation of protocols like the EMERALD-US algorithm can help physicians in expedited decision-making and diagnosis without increasing ED visit durations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03691857\">NCT03691857<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101432","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T02:36:14Z","timestamp":1754879774000},"page":"e101432","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Performance of an ultrasound diagnostic algorithm for acute dyspneic patients in the emergency department: an EMERALD-US protocol"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct03691857","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3583-7172","authenticated-orcid":false,"given":"Deborah","family":"Jaeger","sequence":"first","affiliation":[{"name":"Lorraine University, Emergency Department, University Hospital of Nancy, Nancy, Lorraine, France"},{"name":"Lorraine University, CIC-P, University Hospital of Nancy, Vandoeuvre les Nancy, Lorraine, France"},{"name":"Lorraine University, UMR_S 1116, Faculty of M\u00e9decine of Nancy, Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlene","family":"Duchanois","sequence":"additional","affiliation":[{"name":"Lorraine University, Emergency Department, University Hospital of Nancy, Nancy, Lorraine, France"},{"name":"Lorraine University, UMR_S 1116, Faculty of M\u00e9decine of Nancy, Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Duarte","sequence":"additional","affiliation":[{"name":"Lorraine University, CIC-P, University Hospital of Nancy, Vandoeuvre les Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xavier","family":"Lepage","sequence":"additional","affiliation":[{"name":"Lorraine University, CIC-P, University Hospital of Nancy, Vandoeuvre les Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludovic","family":"Merckle","sequence":"additional","affiliation":[{"name":"Lorraine University, CIC-P, University Hospital of Nancy, Vandoeuvre les Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrien","family":"Bassand","sequence":"additional","affiliation":[{"name":"Lorraine University, Emergency Department, University Hospital of Nancy, Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aur\u00e9lien","family":"Buessler","sequence":"additional","affiliation":[{"name":"Lorraine University, Emergency Department, University Hospital of Nancy, Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8819-0061","authenticated-orcid":false,"given":"Anthony","family":"Chauvin","sequence":"additional","affiliation":[{"name":"Emergency Department, Assistance Publique - Hopitaux de Paris, Lariboisi\u00e8re Hospital, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e9r\u00f4me","family":"Bokobza","sequence":"additional","affiliation":[{"name":"Adult Emergency Department, Assistance Publique H\u00f4pitaux de Paris, Hopital Cochin, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Penine","sequence":"additional","affiliation":[{"name":"Emergency Department, Charleville-Maizi\u00e8res Hospital, Charleville Maizi\u00e8res, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetan","family":"Giacomin","sequence":"additional","affiliation":[{"name":"Lorraine University, Emergency Department, University Hospital of Nancy, Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyrielle","family":"Brossard","sequence":"additional","affiliation":[{"name":"Emergency Department, CHR Metz-Thionville, Metz, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Girerd","sequence":"additional","affiliation":[{"name":"Lorraine University, CIC-P, University Hospital of Nancy, Vandoeuvre les Nancy, Lorraine, France"},{"name":"Lorraine University, UMR_S 1116, Faculty of M\u00e9decine of Nancy, Nancy, Lorraine, France"},{"name":"Lorraine University, Cardiology Department, University Hospital of Nancy, Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahar","family":"Chouihed","sequence":"additional","affiliation":[{"name":"Lorraine University, Emergency Department, University Hospital of Nancy, Nancy, Lorraine, France"},{"name":"Lorraine University, CIC-P, University Hospital of Nancy, Vandoeuvre les Nancy, Lorraine, France"},{"name":"Lorraine University, UMR_S 1116, Faculty of M\u00e9decine of Nancy, Nancy, Lorraine, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,10]]},"reference":[{"key":"2025123106455884000_15.8.e101432.1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/144.4.826"},{"key":"2025123106455884000_15.8.e101432.2","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s11739-023-03322-8","article-title":"Acute dyspnea in the emergency department: a clinical review","volume":"18","author":"Santus","year":"2023","journal-title":"Intern Emerg Med"},{"key":"2025123106455884000_15.8.e101432.3","doi-asserted-by":"crossref","unstructured":"Cairns C , Kang K . 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