Improving the value of ultrasound in children with suspected appendicitis: a prospective study integrating secondary sonographic signs

Ultrasonography
Tristan ReddanKerrie Mengersen

Abstract

The purpose of this study was to determine whether the awareness and inclusion of secondary sonographic signs of appendicitis, in combination with a structured evaluation as part of engagement and training for sonographers, improved appendix visualization rates and reduced equivocal findings in children with suspected acute appendicitis. This was a prospective study of 230 children at a tertiary children's hospital in Australia referred for an ultrasound examination of suspected appendicitis. The ultrasound findings, radiology reports, histology, clinical results, and follow-up were collated. Secondary signs were used as an additional assessment of the likelihood of disease where possible, even in the absence of an identified appendix. The implementation of a structured evaluation as part of sonographer engagement and training resulted in a 28% improvement in appendix visualization (68.7%) compared with a prior retrospective study in a similar population (40.7%). The diagnostic accuracy was 91.7%, with likelihood ratios suggesting a meaningful influence of the pre-test probability of appendicitis in children studied (positive likelihood ratio, 11.22; negative likelihood ratio, 0.09.). Only 7.8% of the findings were equivocal. A...Continue Reading

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Citations

May 21, 2019·Ultrasound Quarterly·Stacy D O'ConnorParag P Tolat
Aug 14, 2019·Healthcare Informatics Research·Tristan ReddanKerrie Mengersen
May 29, 2021·Pediatric Radiology·Jeffrey T NealCarol E Barnewolt
Aug 15, 2021·Advances in Surgery·Katherine He, Shawn J Rangel

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