title: Office-based ultrasound screening for abdominal aortic aneurysm.
abstract: OBJECTIVE
  To assess the efficacy of an office-based, family physician–administered ultrasound examination to screen for abdominal aortic aneurysm (AAA).
  
  
  METHODS
  A prospective observational study. Consecutive patients were approached by nonphysician staff.
  
  
  METHODS
  Rural family physician offices in Grand Forks and Revelstoke, BC.
  
  
  METHODS
  The Canadian Society for Vascular Surgery screening recommendations for AAA were used to help select patients who were at risk of AAA. All men 65 years of age or older were included. Women 65 years of age or older were included if they were current smokers or had diabetes, hypertension, a history of coronary artery disease, or a family history of AAA.
  
  
  METHODS
  A focused “quick screen”, which measured the maximal diameter of the abdominal aorta using point-of-care ultrasound technology, was performed in the office by a resident physician trained in emergency ultrasonography. Each patient was then booked for a criterion standard scan (i.e., a conventional abdominal ultrasound scan performed by a technician and interpreted by a radiologist). The maximal abdominal aortic diameter measured by ultrasound in the office was compared with that measured by the criterion standard method. The time to screen each patient was recorded.
  
  
  RESULTS
  Forty-five patients were included in data analysis; 62% of participants were men. The mean age was 73 years. The mean pairwise difference between the office-based ultrasound scan and the criterion standard scan was not statistically significant. The mean absolute difference between the 2 scans was 0.20 cm (95% CI 0.15 to 0.25 cm). Correlation between the scans was 0.81. The office-based ultrasound scan had both a sensitivity and a specificity of 100%. The mean time to screen each patient was 212 seconds (95% CI 194 to 230 seconds).
  
  
  CONCLUSIONS
  Abdominal aortic aneurysm screening can be safely performed in the office by family physicians who are trained to use point-of- care ultrasound technology. The screening test can be completed within the time constraints of a busy family practice office visit. The benefit of screening for AAA in rural patients might be great if local diagnostic ultrasound service and emergent transport to a vascular surgeon are not available.
authors.affiliation: Colchester Regional Hospital, Truro, NS. beau.blois@dal.ca
authors.forename: Beau
authors.initials: B
authors.lastname: Blois
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D009819:Office Visits; D018579:Patient Selection; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012307:Risk Factors; D019035:Rural Health Services; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography