The role of abdominal radiography in the diagnosis of intussusception when interpreted by pediatric emergency physicians.
OBJECTIVE
To evaluate the sensitivity and specificity of abdominal x-rays in the diagnosis of intussusception when interpreted by pediatric emergency physicians.


METHODS
This was a prospective experimental study. Participants were board-certified/eligible pediatric emergency physicians. They evaluated a module containing radiographs of 50 cases of intussusception and 50 controls, matched for age and sex. For each x-ray, the physicians stated whether the x-ray increased, decreased or did not affect suspicion of intussusception. The primary outcome was the percentage of cases for which physicians stated that the x-ray increased their level of suspicion (sensitivity). Secondary outcomes included the proportion of false-negative results and specificity.


RESULTS
Fourteen of 15 eligible physicians participated in the study. Overall, abdominal radiography increased the index of suspicion of intussusception in 48% of cases (sensitivity) and 21% of controls; however, in 11% of cases, the abdominal x-rays were incorrectly interpreted as being reassuring. The specificity was 21%. The radiographs were deemed equivocal for 41% of cases and 58% of controls.


CONCLUSIONS
Abdominal x-rays have a low sensitivity and specificity for diagnosing intussusception when interpreted by pediatric emergency physicians.
Morrison
Jessica
J
Pediatrics Residency Program, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada.
Lucas
Nathalie
N
Gravel
Jocelyn
J
D002648:Child; D002983:Clinical Competence; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007443:Intussusception / Q000175:diagnosis*; D008297:Male; D010372:Pediatrics; D011446:Prospective Studies; D011860:Radiography, Abdominal; D018570:Risk Assessment; D012680:Sensitivity and Specificity