Robert Ohle

Years since your first academic appointment: No academic appointment

Title: Do we need a clinical decision rule for acute aortic syndrome?

Full author list: Ohle, R. Perry, J.

Introduction Diagnosis of acute aortic syndrome (AAS) in the emergency department is difficult. Up to 38% of cases are missed on first presentation leading to increased morbidity and mortality. Current investigation is inefficient with 98.4% of advanced imaging negative. A clinical decision rule could potentially improve efficiency and accuracy.


  1. To identify high risk clinical characteristics for acute aortic syndrome(AAS) in patients presenting with acute onset pain.
  2. Construct a highly sensitive clinical decision aid for AAS
  3. Construct a risk stratification aid for AAS

Design Multicentre prospective cohort study

Setting tertiary care teaching hospitals in Canada.

Participants adults presenting with chest, abdominal, flank, back or neck pain for <2 weeks without confirmed diagnosis after initial clinical encounter.

Main outcome measures acute aortic syndrome as defined by CTA of chest and or abdomen.

Importance This score will improve patient care and potentially lower health care costs by identifying those who do not require a computed tomography. In addition it will improve physician sensitivity in diagnosing AAS reducing missed diagnoses.


  1. Is a step wedge randomized implementation trial of a diagnostic algorithm constructed from retrospective data a more feasible approach?