Not long ago I got to play Piratecat's "Separation Anxiety" game, which was easily the best Dread game I've ever played. It helped a lot that the group of players was one of the finest collection of gamers that I've ever sat in a room with.
But it had a few things built in that really just made it amazing and I think they are worth mentioning. I'll do this without giving any spoilers.
The basis for the game is that the characters are on a reality TV game show where they are trying to (presumably) fix their marriages. There were three sets of couples played by the players and another couple played by the GM.
It seems like a pretty basic setup but it's genius for a couple of key reasons. First, you already have a character in the game that you're deeply tied to because they are your spouse. This might mean that you love them or that you hate them or that you want to see them live or die, but regardless it ties you strongly to them.
The other thing is that I've seen some Dread games, especially those with new players, where it is very hard to break the "PCs are a party" mindset where you don't want to ever get in each other's way. This results in not taking too many pulls early unless faced with some obvious outside problem. But this game is a game show where you're competing directly with the other players. The pulls started happening early and often (one player knocked the tower down after what was essentially the first encounter!). This quickly ratchets up the tension for a death by the mid game, which is a good thing in Dread, IMHO.
Finally I loved one other tweak that Piratecat made to the rules, which was to allow one player, once per scene, rather than make a pull to instead sit in the "confessional". This was a separate chair that nobody else was occupying, intended to mimic the solo camera time often shown on reality TV shows. It was hilarious and interesting as a way to reveal more about your character to the players but not to their characters.
Dread is one of the few games that I really love which I've never GMed. I'm now considering doing so using this game or something similar.