A review on using ultrasound for evaluation of pediatric blunt abdominal trauma

2021 ◽  
Author(s):  
Mojtaba Chardouli ◽  
Mohammadreza Yasinzadeh ◽  
Mohammad Meshkini ◽  
Hadi Jalilvand ◽  
Hamed Basir Ghafouri ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Examination ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Cochrane Collaboration ◽  
Medical Subject Headings ◽  
Time Saving ◽  
Predictive Values ◽  
Mesh Terms ◽  
Sensitivity Specificity

This study reviewed the former studies conducted on the usefulness of accuracy of focused assessment with sonography for trauma (FAST) or any plain ultrasonography (US) scan in pediatric blunt abdominal trauma (BAT), to assess its accuracy, sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Searches were conducted using the predefined keywords and Medical Subject Headings (MeSH) terms across MEDLINE (PubMed), Scopus, Web of Science, Cochrane Collaboration Library, Embase, ClinicalTrials.gov, Magiran and SID.ir databases. Duplicate publications were excluded; then the titles and abstracts of eligible studies were reviewed for how they report blunt trauma, pediatric patients, and ultrasound modality in their text. Cochrane RevMan version 5.3 was used for the results analysis and assessing the risk of bias in the studies. Out of 923 studies, 902 were excluded, and only 19 articles were included in this review, out of which one was a randomized clinical trial (RCT), three were cohort studies, two were contrast-enhanced US (CEUS) studies, and 13 were prospective or retrospective descriptive studies. The total population studied in the articles was 3454 patients. The results showed that the specificity of US in pediatric BAT was 93%, the sensitivity was 54%, and the PPV in comparison to clinical examination was 73% versus 37%. CEUS protocol achieved 100% in both sensitivity and specificity analysis. The only RCT study which included about 28% of the studies population also reached a sensitivity and specificity of 97% and 98%, respectively using a combinational protocol of clinical examination, laboratory investigation, and US assessment. Ultrasonography does not provide more results than clinical examination, though better PPV results. A combination of follow-up, US examination, and laboratory requests may also have more accurate results. Moreover, a CEUS protocol may reach that goal with an acceptable time-saving outcome, but it needs more studies to be confirmed.

scholarly journals A New Evaluation Method for Lumbar Spinal Instability: Passive Lumbar Extension Test

2006 ◽  
Vol 86 (12) ◽  
pp. 1661-1667 ◽  
Author(s):  
Yuichi Kasai ◽  
Koichiro Morishita ◽  
Eiji Kawakita ◽  
Tetsushi Kondo ◽  
Atsumasa Uchida
Keyword(s):  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Evaluation Method ◽  
Positive Likelihood Ratio ◽  
Spinal Instability ◽  
Predictive Values ◽  
Flexion Extension ◽  
Lumbar Extension ◽  
Lumbar Spinal ◽  
Sensitivity Specificity

Abstract Background and PurposeAlthough many studies have described clinical examination measures for the diagnosis of lumbar spinal instability, few of them have investigated the sensitivity and specificity of the measures that were used. The authors devised a passive lumbar extension (PLE) test for assessing lumbar spinal instability. The purpose of this study was to investigate the sensitivity, specificity, and positive likelihood ratio of this test. Subjects and Methods. The PLE test as well as the instability catch sign, painful catch sign, and apprehension sign tests were done for 122 subjects with lumbar degenerative diseases. The subjects were divided into 2 groups—instability positive and instability negative—on the basis of findings on flexion-extension films of the lumbar spine. The sensitivity, specificity, predictive values, and positive likelihood ratio of each test were investigated. Results. The sensitivity and specificity of the PLE test were 84.2% and 90.4%, respectively. These values were higher than those of other signs. The positive likelihood ratio of the PLE test was 8.84 (95% confidence interval=4.51–17.33). Discussion and Conclusion. The PLE test is an effective method for examining patients for lumbar spinal instability and can be performed easily in an outpatient clinic.

scholarly journals Evaluation and management of blunt injury abdomen based on focussed assessment with sonography in trauma

2020 ◽  
Vol 9 (1) ◽  
pp. 61
Author(s):  
Sameer Ahmed
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Blunt Injury ◽  
Predictive Values ◽  
Bedside Test ◽  
Intraabdominal Injuries ◽  
Low Sensitivity

Background: The initial evaluation of patient with multiple trauma is a challenging task. FAST (focussed assessment with sonography in trauma) provides a viable alternative to computed tomography in blunt abdominal trauma patient. The aim of this study was to find the accuracy and utility of FAST in clinical decision making, as well as limitations.Methods: A total of 100 patients with blunt abdominal trauma who underwent FAST examination were included. Positive scan was defined as the presence of free intraperitoneal fluid. The sonographic scoring for operating room triage in trauma (SSORTT Score) was calculated using cumulative sum of ultrasound score, systolic blood pressure, and pulse rate. FAST findings were compared with computed tomography findings and in operated cases compared with surgical findings & clinical outcome.Results: We determined SSORTT score in all 100 cases. In our study, the sensitivity, specificity, positive and negative predictive values for FAST in identifying intraabdominal injuries were 93.9%, 94.2%, 87.5%, and 97.2%. In our study we found out that patients with a SSORTT score of 2 and above had a high likelihood of requiring a therapeutic laparotomy.Conclusions: In our study we found that FAST is a rapid, reproducible, portable and non-invasive bedside test, and can be performed at the same time as resuscitation. Ultrasound is limited mainly by its low sensitivity in directly demonstrating solid organs injuries.

scholarly journals Urea-Fibrinogen Slide Coagulase Test – A Simple Alternative Method for the Rapid Identification of Staphylococcus aureus

2017 ◽  
Vol 10 (1) ◽  
pp. 5-10
Author(s):  
Binita Koirala Sharma ◽  
S Gokhale ◽  
K Sharma
Keyword(s):  
Staphylococcus Aureus ◽  
Sensitivity And Specificity ◽  
Reference Method ◽  
Cost Effective ◽  
Rapid Identification ◽  
Accurate Identification ◽  
Predictive Values ◽  
Negative Results ◽  
Animal Pathogens ◽  
Sensitivity Specificity

Introduction: The accurate identification of Staphylococcus aureus clinical isolates requires a series of tests. Morphological features and slide coagulase test are two criteria on which S. aureus are identified. Resort to tube coagulase test is sought when results of slide coagulase test are equivocal or doubtful. Both coagulase tests detect the enzymes that convert fibrinogen into fibrin. Human, rabbit or sheep pooled plasma is used as substrate for both tests. Slide coagulase test is simpler and faster as compared to tube coagulase test. The plasma could be carrier of many human and animal pathogens like HIV, HBV, HCV etc. Storage of plasma for longer duration is fraught with chances of contamination. Improperly stored plasma can lead to false positive or negative results. Citrated plasma may be unsuitable for this test if contaminated with citrate utilizing bacteria. Considering the role of S. aureus as a common etiological agent in nosocomial and community infections, there is a need of implementing rapid, easy and cost-effective phenotypic test.Objectives: Considering the disadvantages and risks associated with fresh plasma, this study aims to launch for safer, more reliable substitute with longer shelf life that may provide reliable results for prompt identification of S. aureus by slide coagulase test.Methods: The present work evaluates slide coagulase test (SCT), and urea fibrinogen slide coagulase test (UF-SCT) for S. aureus detection considering Tube coagulase test (TCT) as the reference method. Sensitivity, specificity, positive predictive value and negative predictive values of SCT and UF-SCT were calculated using TCT as gold standard. Results: A total of 150 staphylococcal isolates from different clinical specimens ere selected for the evaluation of coagulase tests. All the specimens were subjected to SCT, UF-SCT and TCT. The UF-SCT showed better sensitivity (95.04%), specificity (100%), PPV (100%), and NPV (82.85%) with reference to TCT. UF-SCT showed similar sensitivity and specificity to SCT. None of the isolates were negative in UF-SCT and positive in SCT. Since UF-SCT does not incorporate plasma directly and at the same time has a very good sensitivity and specificity, it is recommended that UF-SCT could replace SCT for identification of S. aureus.Conclusion: The findings of present study shall encourage laboratories to use the urea-fibrinogen slide coagulase test routinely for the rapid identification of S aureus.Journal of Gandaki Medical College  Vol. 10, No. 1, 2017, Page: 5-10

scholarly journals Validation of an extended French version of ID Migraine™ as a migraine-screening tool

Cephalalgia ◽  
2014 ◽  
Vol 35 (5) ◽  
pp. 437-442 ◽  
Author(s):  
Sylvie Streel ◽  
Anne-Françoise Donneau ◽  
Nadia Dardenne ◽  
Axelle Hoge ◽  
Olivier Bruyère ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Screening Tool ◽  
Epidemiological Studies ◽  
Predictive Values ◽  
French Version ◽  
Gender Education ◽  
French Speaking ◽  
Id Migraine ◽  
Sensitivity Specificity

Introduction Migraine has a considerable social, economic, physical and emotional burden but remains underdiagnosed and undertreated. A specific migraine screening tool could help remove barriers to health care and be an attractive instrument for epidemiological studies. The objective of this work was to assess the validity of an extended French version of ID Migraine™ as a migraine-screening tool. Methods Sixty-seven subjects from the NESCaV study (2010–2012) completed the migraine screen and were diagnosed by a neurologist specializing in headache medicine using the International Classification of Headache Disorders, 2nd edition criteria (gold standard). Agreement between the two diagnoses was evaluated by Cohen kappa coefficient (κ). Sensitivity, specificity and predictive values of the migraine screen were calculated. Results Migraine was diagnosed in 21 (31.3%) of the 67 subjects according to the screening tool and in 24 (35.8%) by the neurologist (κ = 0.90). The prevalence of migraine was unrelated to age, gender, education and perception of financial resources. Sensitivity and specificity of the screen were 87.5% and 100%, respectively. The screen prevalence of migraine with aura was 10.4% (sensitivity and specificity: 83.3% and 96.7%, respectively). Conclusion The extended French version of ID Migraine™ (ef-ID Migraine) is a validated tool to screen migraine in French-speaking countries.

scholarly journals Commercial AI solutions in detecting COVID-19 pneumonia in chest CT: not yet ready for clinical implementation?

2021 ◽  
Author(s):  
Florian Jungmann ◽  
Lukas Müller ◽  
Felix Hahn ◽  
Maximilian Weustenfeld ◽  
Ann-Kathrin Dapper ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Subgroup Analysis ◽  
Chest Ct ◽  
Ground Glass ◽  
Clinical Implementation ◽  
Clinical Routine ◽  
Predictive Values ◽  
Clinical Dataset ◽  
Sensitivity Specificity ◽  
Ct Studies

Abstract Objectives In response to the COVID-19 pandemic, many researchers have developed artificial intelligence (AI) tools to differentiate COVID-19 pneumonia from other conditions in chest CT. However, in many cases, performance has not been clinically validated. The aim of this study was to evaluate the performance of commercial AI solutions in differentiating COVID-19 pneumonia from other lung conditions. Methods Four commercial AI solutions were evaluated on a dual-center clinical dataset consisting of 500 CT studies; COVID-19 pneumonia was microbiologically proven in 50 of these. Sensitivity, specificity, positive and negative predictive values, and AUC were calculated. In a subgroup analysis, the performance of the AI solutions in differentiating COVID-19 pneumonia from other conditions was evaluated in CT studies with ground-glass opacities (GGOs). Results Sensitivity and specificity ranges were 62–96% and 31–80%, respectively. Negative and positive predictive values ranged between 82–99% and 19–25%, respectively. AUC was in the range 0.54–0.79. In CT studies with GGO, sensitivity remained unchanged. However, specificity was lower, and ranged between 15 and 53%. AUC for studies with GGO was in the range 0.54–0.69. Conclusions This study highlights the variable specificity and low positive predictive value of AI solutions in diagnosing COVID-19 pneumonia in chest CT. However, one solution yielded acceptable values for sensitivity. Thus, with further improvement, commercial AI solutions currently under development have the potential to be integrated as alert tools in clinical routine workflow. Randomized trials are needed to assess the true benefits and also potential harms of the use of AI in image analysis. Key Points • Commercial AI solutions achieved a sensitivity and specificity ranging from 62 to 96% and from 31 to 80%, respectively, in identifying patients suspicious for COVID-19 in a clinical dataset. • Sensitivity remained within the same range, while specificity was even lower in subgroup analysis of CT studies with ground-glass opacities, and interrater agreement between the commercial AI solutions was minimal to nonexistent. • Thus, commercial AI solutions have the potential to be integrated as alert tools for the detection of patients with lung changes suspicious for COVID-19 pneumonia in a clinical routine workflow, if further improvement is made.

scholarly journals VAGINAL SONOGRAPHY a HYSTEROSCOPY

2009 ◽  
Vol 16 (03) ◽  
pp. 432-437
Author(s):  
MASOMEH ASGHARNIA ◽  
Zahra Mohammad Tabar ◽  
MARZIEH MEHRAFZA ◽  
Mary am Shakiba ◽  
MONA OUDI ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
Therapeutic Modality ◽  
Histological Evaluation ◽  
Complete Evaluation ◽  
Cross Sectional ◽  
Predictive Values ◽  
Infertile Women ◽  
Sensitivity Specificity

B a c k g r o u n d : Hysteroscopy is a valuable diagnostic and therapeutic modality in the management of infertility. A i m : To evaluatethe consistency of hysteroscopy based on a histopathological report from endometrial specimens for intrauterine disorders. Materials andMethods: This is a cross-sectional study. The study included 115 infertile patients. All were admitted for investigation of infertile women beforeassisted reproduction in Mehr infertility institute between 2006 and 2007 hysteroscopy, and histological evaluation of endometrial biopsyperformed.We compared the efficacy of hysteroscopy in the diagnosis of benign intrauterine pathology in infertile women in whom the diagnosiswas confirmed by histologic studies. The women had a complete evaluation with preoperative hysteroscopy, and histological analysis of uterinecavity specimens. Sensitivity, specificity, predictive and negative predictive values were calculated for hysteroscopy considering the histologicalstudy as 100%. Results: Sensitivity and specificity of sonography in diagnosing the polyp were stated 81 % and 64% respectively. Sensitivityand specificity of hysteroscopy showed of polyps revealed 85% and 84% respectively. The results indicated that Sensitivity and specificity ofsonography in diagnosing the myoma were 25% and 98% respectively. Sensitivity and specificity of hysteroscopy in diagnosing the myomawere expressed 50% and 93% respectively. C o n c l u s i o n : Hysteroscopy is a safe and rapid direct visualisation of the uterine cavity. We believeit should be replaced by the diagnostic hysteroscopy as a first line infertility investigation.

scholarly journals Focused abdominal ultrasound for blunt trauma in an emergency department without advanced imaging or on-site surgical capability

CJEM ◽  
2004 ◽  
Vol 6 (06) ◽  
pp. 408-415 ◽  
Author(s):  
Michael Shuster ◽  
Riyad B. Abu-Laban ◽  
Jeff Boyd ◽  
Charles Gauthier ◽  
Sandra Mergler ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Tertiary Care ◽  
False Negative ◽  
Rural Hospital ◽  
Definitive Treatment ◽  
Clinical Indication ◽  
Emergency Physicians ◽  
Advanced Imaging ◽  
Predictive Values

ABSTRACT:Objectives:To determine whether focused abdominal sonogram for trauma (FAST) in a rural hospital provides information that prompts immediate transfer to a tertiary care facility for patients with blunt abdominal trauma who would otherwise be discharged or held for observation.Methods:Prior to the study, participating emergency physicians underwent a minimum of 30 hours of ultrasound training. All patients who presented with blunt abdominal trauma to our rural hospital between Mar. 1, 2002, and Apr. 30, 2003, were eligible for study. Following a history and physical examination, the emergency physician documented his or her disposition decision. A FAST was then performed, and the disposition reconsidered in light of the FAST results.Results:Sixty-seven FAST exams were performed on 65 patients. Three examinations (4.5%) were true-positive (95% confidence interval [CI] 0.9%–12.5%); 60 (89.6%) were true-negative (95% CI 79.7%–95.7%), 4 (6%) were false-negative (95% CI 1.7%–14.6%) and none (0%) were false-positive (95% CI 0%–5.4%). These values reflect sensitivity, specificity, negative predictive value and positive predictive values of 43%, 100%, 94% and 100% respectively. FAST results did not alter the decision to transfer any patient (0%: 95% CI 0.0%–5.4%), although one positive FAST may have led to an expedited transfer. One of 38 patients who was discharged after a negative FAST study returned 24 hours later because of worsening symptoms, and was ultimately found to have splenic and pancreatic injuries.Conclusions:This study failed to demonstrate that FAST improves disposition decisions for patients with blunt abdominal trauma who are evaluated in a hospital without advanced imaging or on-site surgical capability. However, the study is not sufficiently powered to rule out a role for FAST in these circumstances, and our data suggest that up to 5.4% of transfer decisions could be influenced by FAST. Rural emergency physicians should not allow a negative FAST study to override a clinical indication for transfer to a trauma centre; however, positive FAST studies can be used to accelerate transfer for definitive treatment.

Sign in / Sign up

Export Citation Format

Share Document