• Emerg Med Australas · Apr 2023

    Accuracy and clinical use of biliary point-of-care ultrasound: A retrospective cohort study.

    • Juliette Archer and Sierra Beck.
    • Department of Medicine, University of Otago, Dunedin, New Zealand.
    • Emerg Med Australas. 2023 Apr 1; 35 (2): 218224218-224.

    ObjectivesTo assess the utilisation and diagnostic accuracy of biliary point-of-care ultrasounds (POCUS) performed and archived in a single New Zealand ED.MethodsA retrospective cohort study of clinically indicated biliary POCUS, archived from 1 October 2019 to 20 May 2020. POCUS interpretation was compared to expert review and radiology imaging when available. The clinician interpretations, diagnostic imaging results and surgical referrals were extracted from electronic medical records. Archived POCUS images were retrospectively reviewed by an expert to determine diagnostic quality, sonographic findings and imaging errors.ResultsA total of 133 ultrasounds were included; 118 (90%) archived images were of diagnostic quality. The presence or absence of gallstones was documented in 124 (93%), and other sonographic findings were less consistently documented. There was almost perfect agreement with expert review for gallstones (κ = 0.82, 95% confidence interval 0.72-0.93) and substantial agreement for wall thickening (κ = 0.63, 95% confidence interval 0.42-0.83). For patients discharged following negative POCUS without radiology imaging or surgical review no patients returned and received a diagnosis of cholecystitis over 6 months of follow-up. Imaging errors included failure to visualise the gallbladder neck, misinterpretation of artefacts and technical errors in measurement of the gallbladder wall.ConclusionBiliary POCUS was primarily utilised for and was accurate for the detection of gallstones. Further quality assurance and training could be directed at earlier credentialing to address technical errors and improved documentation of POCUS findings.© 2022 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…