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Intussusception in children: can we rely on screening sonography performed by junior residents?
Iris Eshed1, Arkadi Gorenstein, Francis Serour
1Department of Diagnostic Radiology, The E. Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Giborim, Holon, Tel Aviv, Isreal. irisar@netvision.net.il
Insights
Junior residents demonstrate high accuracy in diagnosing intussusception using ultrasonography (US), performing comparably to experienced staff radiologists. Their skill in US screening is well-regarded by pediatricians.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
- Gastrointestinal Disorders
Background:
- Ultrasonography (US) is a critical diagnostic modality for suspected intussusception in pediatric patients.
- Accurate and timely diagnosis is essential for effective management and improved patient outcomes.
Purpose of the Study:
- To retrospectively assess the diagnostic accuracy and performance of junior residents interpreting screening ultrasonography for intussusception.
- To compare the performance of junior residents with that of senior residents and staff radiologists.
Main Methods:
- A retrospective analysis of 151 pediatric patients with suspected intussusception who underwent screening ultrasonography between January 1999 and February 2003.
- Patients were categorized based on the interpreting physician: staff radiologist, senior resident, or junior resident.
Main Results:
- Overall diagnostic accuracy for ultrasonography was 93%, with sensitivity of 84% and specificity of 97%.
- Junior residents achieved an accuracy rate of 95%, sensitivity of 83%, and specificity of 97%, comparable to staff radiologists (92% accuracy, 85% sensitivity, 98% specificity).
- Performance metrics for senior residents were also high, with 94% accuracy, 75% sensitivity, and 96% specificity.
Conclusions:
- Junior residents exhibit diagnostic performance in screening ultrasonography for intussusception that is equivalent to that of experienced staff radiologists.
- The proficiency of junior residents in this critical diagnostic skill has earned the confidence of pediatric clinicians.
Background:
Ultrasonography is an important tool in the screening and diagnosis of patients with suspected intussusception.
Objective:
To retrospectively evaluate the accuracy and performance of junior residents and compare it to that of senior residents and staff radiologists.
Materials And Methods:
Between January 1999 and February 2003, 151 patients with suspected intussusception underwent screening US. The mean age of the patients was 13.8 months. Patients were divided into three groups according to examiner: staff radiologist, senior resident or junior resident.
Results:
Sixty-five patients had both US and air enema. Forty-four patients had a positive US result; 37 (84%) were true positive and 7 (16%) were false positive. Twenty-one patients had a negative US result; 18 (86%) were true negative and 3 (14%) were false negative. Eighty-six patients underwent screening US only and were then kept under observation in the emergency room. They were all diagnosed as having a non-surgical condition. The total accuracy rate was 93%, sensitivity was 84%, specificity was 97%, positive predictive value was 93% and negative predictive value was 94%. Accuracy rate, sensitivity and specificity were 92%, 85% and 98% for staff radiologists, 94%, 75% and 96% for senior residents and 95%, 83% and 97% for junior residents, respectively.
Conclusions:
Junior residents perform as well as staff radiologists in screening US for suspected intussusception and have gained both the respect and confidence of the paediatricians.
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