Bima P, Pivetta E, Nazerian P, et al. - Since integration of the aortic dissection detection risk score (ADD‐RS) with D‐dimer (DD) provides a potential pipeline for standardized diagnostic rule‐out. Researchers performed systematically review to summarized supporting data. They distinguished cross‐sectional studies evaluating integration of ADD‐RS with DD for diagnosis of acute aortic syndromes on MEDLINE, EMBASE and Web Of Science databases. They assessed quality of design and reporting with the QUADAS‐2 and STARD tools. They estimated pooled values for variables exhibiting nonsignificant heterogeneity. Six-hundred eighty studies including a total of 3,804 patients were included in the study. Despite methodologic limitations, the data revealed that integration of ADD‐RS = 0 or ≤ 1 with DD < 500 ng/mL exhibits negligible heterogeneity, and consistently high sensitivity across studies, therefore supporting reliability for diagnostic rule‐out of AASs. Findings supporting ADD‐RS = 0 plus DDage‐adj appear preliminary and need future scrutiny.