The Sonographic Protocol for the Emergent Evaluation of Aortic Dissections (SPEED Protocol): A Multi-Center, Prospective, Observational Study. Gibbons RC, Smith D, Feig R, Mulflur M, Costantino TG. Acad Emerg Med. 2023 Nov 27. doi: 10.1111/acem.14839. Epub ahead of print. PMID: 38010071.
Methods: This was an Institutional Review Board approved, 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 35mm. Investigators present continuous and categorical data as medians with interquartile ranges or proportions with 95% confidence intervals (CIs) and utilized standard 2x2 tables on MedCalc (Version 19.1.6) to calculate test characteristics with 95% CI.

Results: Investigators performed 1314 point-of-care ultrasound examinations, diagnosing 21 Stanford type A and 23 Stanford type B AoD. 41 of the 44 cases had at least one of the aforementioned sonographic findings. The protocol has a sensitivity of 93.2% (95% CI 81.3-98.6), specificity of 90.9 (95% CI 89.2-92.5), and positive and negative predictive values of 26.3% (95% CI 19.6-33.9) and 99.7% (95% CI 99.2-100), respectively, and an accuracy of 91% (95% CI 89.3-92.5).