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Surgeon-performed ultrasound at the bedside for the detection of appendicitis and gallstones: systematic review and meta-analysis

Authors
Journal
The American Journal of Surgery
0002-9610
Publisher
Elsevier
Volume
205
Issue
1
Identifiers
DOI: 10.1016/j.amjsurg.2012.02.017
Keywords
  • Ultrasound
  • Surgeon Performed
  • Appendicitis
  • Gallstones
  • Systematic Review
  • Meta-Analysis
Disciplines
  • Biology
  • Medicine

Abstract

Abstract Background We undertook a systematic review and meta-analysis to compare surgeon-performed ultrasound (SPUS) for suspected appendicitis or gallstone disease to the “gold standard” of pathological examination or radiologist-performed ultrasound (RPUS). Data Sources MEDLINE, Embase, trial registries, conference proceedings, and article reference lists were searched to identify trials and/or studies comparing SPUS with pathology or RPUS as the reference standard. Data were abstracted from eligible studies to produce 2 × 2 contingency tables, permitting the calculation of pooled sensitivity and specificity values. Results Eight studies (1,268 patients) evaluated SPUS for appendicitis. For appendicitis, SPUS had a pooled sensitivity of .92 (95% confidence interval [CI], .887–.939) and a pooled specificity of .96 (95% CI, .946–.974). SPUS for gallstones was evaluated in 8 studies (1,019 patients). The pooled sensitivity was .96 (95% CI, .934–.979), and the specificity was .99 (95% CI .983–.998). Conclusions SPUS achieves acceptable sensitivity and specificity for both gallstones and appendicitis. However, there was some evidence of heterogeneity. Data regarding cost-effectiveness are lacking.

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