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Appendiceal ultrasonography performed by nonradiologists: does it help in the diagnostic process?
D Pohl1, R Golub, G E Schwartz
1Department of Surgery, New York Flushing Hospital Medical Center, 11355, USA.
Summary
Appendiceal ultrasonography is less accurate when performed by unsupervised technicians at night. Daytime studies by supervised technicians show significantly higher sensitivity and positive predictive value for appendicitis diagnosis.
Area of Science:
- Radiology
- Medical Diagnostics
- Abdominal Imaging
Background:
- Appendiceal ultrasonography is a common diagnostic tool for suspected appendicitis.
- Operator experience and supervision may influence diagnostic accuracy.
- Nighttime emergency care often relies on less experienced staff.
Purpose of the Study:
- To compare the diagnostic performance of appendiceal ultrasonography.
- To evaluate studies performed by unsupervised technicians at night versus supervised technicians during the day.
Main Methods:
- Retrospective analysis of 163 appendiceal sonographic examinations.
- Comparison of sensitivity, specificity, and predictive values based on time of day and technician supervision.
- Categorization of examinations into daytime (supervised) and nighttime (unsupervised) groups.
Main Results:
- Daytime examinations (59%) showed significantly higher sensitivity (61%) than nighttime examinations (26%).
- Positive predictive value was also significantly higher during the day (93%) compared to at night (71%).
- Diagnostic accuracy was notably diminished in nighttime, unsupervised studies.
Conclusions:
- Appendiceal ultrasonography is highly operator-dependent.
- Reduced sensitivity and predictive value during nighttime unsupervised examinations render negative results unreliable.
- Experienced radiologist or technician performance is crucial for accurate appendiceal ultrasonography.
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