Accuracy and Interrater Reliability of Point-of-Care Ultrasonography Image Interpretation for Intussusception.

Area of Science:

• Pediatric Emergency Medicine
• Diagnostic Imaging
• Point-of-Care Ultrasound (POCUS)

Background:

• Intussusception is a common surgical emergency in children.
• Accurate and reliable diagnosis is crucial for timely intervention.
• Point-of-care ultrasound (POCUS) is increasingly used in pediatric emergency settings.

Purpose of the Study:

• To assess the accuracy and interrater reliability of POCUS for intussusception identification.
• To compare the performance of expert vs. novice POCUS reviewers.
• To evaluate the reliability of secondary POCUS signs associated with intussusception.

Main Methods:

• Secondary analysis of a prospective, international study of children (3 months-6 years) with suspected intussusception.
• 100 POCUS examinations randomly selected for review by 18 expert and 16 novice POCUS reviewers.
• Accuracy measured by sensitivity/specificity; reliability by Light's κ statistics.

Main Results:

• Expert reviewers achieved higher average sensitivity (94.5%) and specificity (94.3%) compared to novices (84.7% and 80.4%).
• Interrater reliability (κ) was significantly greater for experts (0.679) than novices (0.424) for intussusception identification.
• Reliability for secondary signs like trapped fluid was weak for experts and minimal for novices.

Conclusions:

• Expert POCUS reviewers demonstrate high accuracy in identifying intussusception.
• Moderate interrater reliability exists among expert reviewers for intussusception diagnosis.
• Expert performance in POCUS interpretation for intussusception surpasses that of novice reviewers.