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Auricular assessment for abdominal pain: A prospective double-blind pilot study on diagnostic potential of auricular
Erfan Ghanad1, Johannes Schulze Twenhoeven2, Yuan Chu2
1Department of Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68167, Baden-Wurttemberg, Germany; Department of Anesthesiology, Intensive Care and Pain Medicine, University Medical Centre Mannheim, University of Heidelberg, Heidelberg 68167, Baden-Wurttemberg, Germany.
Objective:
This study investigated the association between abdominal organ diseases and corresponding auricular regions in patients with acute abdominal pain, seeking to assess the diagnostic utility of auricular assessment.
Methods:
This prospective, double-blind, observational pilot study was conducted from May 2022 to August 2023. Patients presenting with abdominal pain in the emergency department and meeting specific inclusion criteria were recruited. The auricular examination involved palpating the concha and helix areas for tender points corresponding to abdominal organs based on Nogier and Bahr's auricular map. To assess diagnostic accuracy, sensitivity, specificity and likelihood ratios were calculated by comparing the presence of auricular tender points with the patients' confirmed clinical diagnoses.
Results:
Of the 152 screened patients, 104 (68%) received a specific diagnosis related to abdominal organs. For all organs diagnosed with dysfunction in more than five patients, the correlated locations on the auricle, identified by Nogier and Bahr, were either among the most common or the most sensitive points. High sensitivities were observed for conditions affecting the stomach (93%), small intestine (91%) and liver (71%). Specificities were high for certain organs, such as the ureter (86%) and gallbladder (70%), with relevant positive and negative likelihood ratios for the stomach and appendix. Negative predictive values were particularly strong for the stomach (98%), appendix (94.4%), small intestine (93.4%) and bladder (96.6%).
Conclusion:
This study demonstrated a possible association between abdominal organ diseases and specific auricular regions defined by Nogier and Bahr. Auricular assessment could potentially be added as a non-invasive complementary diagnostic tool. However, further studies with larger cohorts are needed to assess the correlation.
Trial Registration:
German Clinical Trials Register (https://drks.de); trial ID: DRKS00030318.
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