Pocket-sized hand-held ultrasound for evaluating pediatric functional constipation by both novice and expert
Pola Waissman1, Ron Berant2, Lisa Amir2
1Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Ariel, Israel.
Insights
Pocket-sized ultrasound (PsUS) is a valid and reliable tool for assessing pediatric functional constipation (PFC). Clinicians with varying ultrasound experience can effectively use PsUS for PFC assessment.
Area of Science:
- Pediatric gastroenterology
- Medical imaging technology
- Diagnostic tools
Background:
- Pediatric functional constipation (PFC) presents a significant global health challenge.
- Accurate assessment of PFC is crucial for effective management.
- Current assessment methods may have limitations in accessibility and ease of use.
Purpose of the Study:
- To evaluate the utility of pocket-sized ultrasound (PsUS) for assessing pediatric functional constipation (PFC).
- To determine the validity of PsUS in measuring key rectal parameters (transverse rectal diameter and rectal anterior wall thickness).
- To assess the agreement between expert and novice clinicians using PsUS for PFC evaluation.
Main Methods:
- A cross-sectional study involving 52 children (28 with PFC, 24 controls) aged 4-14 years.
- Measurements of transverse rectal diameter (TRD) and rectal anterior wall thickness (RAWT) were performed using both conventional ultrasound (US) and PsUS.
- Inter-rater reliability (experienced vs. novice clinician) and validity against conventional US were assessed using intraclass correlation coefficients (ICCs). Diagnostic accuracy was evaluated via receiver operating characteristic (ROC) analysis.
Main Results:
- High agreement was observed between experienced and novice clinicians for both conventional US and PsUS measurements (ICCs ranging from 0.97 to 0.99).
- PsUS demonstrated robust validity compared to conventional US, with ICCs of 0.96 for TRD and 0.87 for RAWT.
- ROC analysis indicated high diagnostic accuracy for PsUS in identifying PFC, with areas under the curve (AUC) of 0.88 for TRD and 0.91 for RAWT.
Conclusions:
- Pocket-sized ultrasound (PsUS) is a valid and reliable tool for assessing pediatric functional constipation (PFC).
- PsUS can be effectively utilized by clinicians regardless of their prior ultrasound experience.
- This technology offers a promising, accessible option for PFC assessment in clinical practice.
Background/Objectives:
Pediatric functional constipation (PFC) is a global health concern. This study evaluates the utility of pocket-sized ultrasound (PsUS) as a tool for assessing PFC among clinicians with varying levels of ultrasound (US) experience. We assessed the validity of PsUS in measuring transverse rectal diameter (TRD) and rectal anterior wall thickness (RAWT) compared to conventional US and to evaluate agreement between expert and novice clinicians.
Methods:
In this cross-sectional study, TRD and RAWT were measured using conventional US and PsUS in 52 children (PFC: n = 28; non-constipated: n = 24), aged 4-14 years. Measurements were performed by an experienced and a novice clinician. Agreement and validity were assessed using intraclass correlation coefficients (ICCs), and diagnostic accuracy was evaluated using receiver operating characteristic (ROC) analysis.
Results:
High agreement was found between the experienced and novice clinicians in assessing PFC using conventional US (ICC for TRD = 0.98, 95% CI: 0.98-0.99; ICC for RAWT = 0.98, 95% CI: 0.97-0.99) and PsUS (ICC for TRD = 0.99, 95% CI: 0.97-0.99; ICC for RAWT = 0.97, 95% CI: 0.96-0.98). PsUS showed robust validity compared to conventional US (ICCs of 0.96 for TRD and 0.87 for RAWT). ROC analysis showed high diagnostic accuracy for PsUS at TRD [area under the curve (AUC) = 0.88, cut-off 30.25 mm] and RAWT (AUC = 0.91, cut-off 2.05 mm).
Conclusions:
These results suggest PsUS is a valid and reliable tool for assessing PFC, that can be used by clinicians with varying levels of US experience.
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