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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >The learning curve in diagnosing acute appendicitis with emergency sonography among novice emergency medicine residents
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The learning curve in diagnosing acute appendicitis with emergency sonography among novice emergency medicine residents

机译：新手急诊医学居民紧急超声诊断急性阑尾炎的学习曲线

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摘要

Abstract Purpose Ultrasonography (US) has good accuracy for diagnosing appendicitis when it is performed by emergency physicians. This study aimed to determine the amount of experience that is required to achieve competency in this field. Methods Three novice emergency medicine residents completed a 1‐day training course regarding the US diagnosis of appendicitis. Then, they performed appendix US in the emergency department on patients complaining of right lower quadrant pain. All included patients also underwent computed tomography or US performed by a board‐certified radiologist, to confirm the emergency US diagnosis. The agreement between the diagnoses of novices and experts was evaluated. Results A total of 266 patients were included, and the overall Cohen's kappa coefficient was 0.77 (95% confidence interval [CI]: 0.69‐0.84). The kappa value of first 20 cases was 0.49 (95% CI: 0.27‐0.71). It increased rapidly during evaluation of the first 20 cases. After the first 20 cases, the kappa coefficient was 0.84 (95% CI: 0.77‐0.92). The sensitivity and specificity values for the first 20 cases were 64.3% (95% CI: 77.6%‐90.7%) and 84.4% (95% CI: 85.4%‐95.4%), respectively. After the first 20 cases, the sensitivity and specificity values increased to 90.9% (95% CI: 83.4%‐95.8%) and 93.5% (95% CI: 87.0%‐97.3%), respectively. Conclusions A minimum of 20 cases are needed to achieve competency in emergency US diagnosis of acute appendicitis.
机译：摘要目的超声检查（美国）在由急诊医生执行时对诊断阑尾炎具有良好的准确性。本研究旨在确定实现该领域能力所需的经验量。方法三项新手急诊医学居民完成了一项关于美国诊断性阑尾炎的一日培训课程。然后，他们在抱怨右下象限疼痛的患者的急诊部门进行附录。所有包括患者也经过计算机断层扫描或由董事会认证放射科医师进行的，以确认您的急救。评估了新手和专家诊断之间的协议。结果总共包括266名患者，整体科恩的Kappa系数为0.77（95％置信区间[CI]：0.69-0.84）。前20例的κ值为0.49（95％CI：0.27-0.71）。在评估前20例时，它会迅速增加。在前20例之前，κ系数为0.84（95％CI：0.77-0.92）。前20例的敏感性和特异性值分别为64.3％（95％CI：77.6％-90.7％）和84.4％（95％CI：85.4％-95.4％）。在前20例之前，敏感性和特异性值分别增加至90.9％（95％CI：83.4％-95.8％）和93.5％（95％CI：87.0％-97.3％）。结论需要至少20例才能实现急性阑尾炎的急救症的能力。

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  • 作者

    Kim Jeehyun; Kim Kipum; Kim Jungwan; Yoo Jungwoo; Jeong Wonjoon; Cho Sunguk; Joo Kihyuk; Cho Yongchul; Lee Jinwoong; Ryu Seung; Yoo Yeonho;

  • 作者单位

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

    Department of Emergency MedicineChungnam National University HospitalDaejeon South Korea;

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  • 正文语种 eng
  • 中图分类 影像诊断学;
  • 关键词

    appendicitis; emergency medicine; ultrasonography;

    机译：阑尾炎;急诊医学;超声检查;

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