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Radiographic stool quantification: an equivalence study of 484 symptomatic and asymptomatic subjects

机译：射线照相粪便量化：484个症状和无症状受试者的等价研究

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Purpose To determine if symptomatic patients referred for radiographic stool quantification have equivalent stool burden to asymptomatic patients. Method This was an IRB-approved HIPAA-compliant retrospective equivalence cohort study. An a priori equivalence power calculation was performed. Consecutive abdominal radiographs performed in adult outpatients with bloating, constipation, diarrhea, or abdominal pain to assess "fecal loading" [n = 242 (fecal cohort)] were compared to those performed in asymptomatic adult outpatients to assess "renal stones" [n = 242 (renal cohort)]. Radiographs were randomized and reviewed by two blinded independent abdominal radiologists. Exclusion criteria, designed to avoid unblinding, included urinary tract calculi ≥ 0.5 cm, multiple urinary tract calculi, and ureteral stent(s). Readers scored all radiographs (n = 484) for stool burden using validated Leech criteria [scale: 0 (none) to 15 (extreme diffuse)]. Mean Leech scores and 95% confidence intervals were calculated. Multivariable generalized linear modeling was performed to adjust for baseline medication use, age, and gender. The adjusted parameter estimate was used to test for equivalence in the mean difference between cohorts using Schuirmann's method of two one-sided t-tests. Inter-reader agreement was assessed with intraclass correlation coefficients. Results Overall mean Leech scores for fecal [6.9 (95% CI 6.7, 7.2)] and renal [7.3 (95% CI 7.1, 7.5)] cohorts were equivalent within a margin of 0.75 (adjusted mean difference: -0.4 [90% CI -0.7, -0.04]; p value= 0.02). Inter-reader agreement was good [ICC: 0.62 (95% CI 0.56, 0.68)]. Conclusion Radiographic stool quantification produces equivalent results in symptomatic and asymptomatic adults and is of uncertain value.
机译：目的是判断出症状患者是否提到了射线照相粪便量化，对无症状患者的粪便负担等同的粪便负担。方法这是IRB批准的HIPAA标准的回顾性等价队列研究。执行先验等效功率计算。将成人门诊患者进行的连续腹部射线照相，以评估“粪便载荷”[n = 242（粪便载体）[n = 242（粪群）]进行比较，以评估“肾脏石头”[n = 242（肾脏队列）]。射线照相被两次盲目的独立腹部放射学家随机化并审查。排除标准，旨在避免未粘连，包括尿路结算≥0.5cm，多尿道结石和输尿管支架。读者使用验证的Leech标准进行粪便负担的所有射线照片（n = 484）[scale：0（无）到15（极端漫反射）]。计算平均水蛭分数和95％的置信区间。进行多变量的广义线性建模，以调整基线药物使用，年龄和性别。调整后的参数估计用于测试使用Schuirmann的两个单侧T检验的群组之间平均差异的等价性。通过脑内相关系数评估读者互相协议。结果粪便的总体平均平均水蛭分数[6.9（95％CI 6.7,7.2）]和肾脏[7.3（95％CI 7.1,7.5）]亚群在0.75的边缘内等同（调整平均差异：-0.4 [90％CI -0.7，-0.04]; p值= 0.02）。读者间协议很好[ICC：0.62（95％CI 0.56,0.68）]。结论放射学粪便量化在症状和无症状成人中产生等效结果，具有不确定的价值。

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