title: Assessment of emergency physician-performed ultrasound in evaluating nonspecific abdominal pain.
abstract: OBJECTIVE
  The objective of this pilot study was to lay the groundwork for future studies assessing the impact of emergency physician-performed ultrasound (EPUS) on diagnostic testing and decision making in emergency department (ED) patients with nonspecific abdominal pain (NSAP).
  
  
  METHODS
  This was a prospective, noninterventional study using a consecutive sample of patients presenting to the ED with NSAP as determined by nursing triage when a participating physician was available. Nonspecific abdominal pain was defined as abdominal pain for which the patient was seeking evaluation without a presumed diagnosis or referral for specific evaluation. Patients were evaluated by a physician who documented their differential diagnosis and planned diagnostic workup. Then, the physician performed EPUS, recorded their findings, and documented their post-EPUS differential diagnosis and planned diagnostic workup. This was compared with the patient's final diagnosis as determined by 2 emergency physicians blinded to the EPUS results.
  
  
  RESULTS
  A total of 128 patients were enrolled. Fifty-eight (45%; 95% confidence interval [CI], 36%-54%) had an improvement in diagnostic accuracy and planned diagnostic workup using EPUS. Sixty-four (50%; 95% CI, 41%-59%) would have been treated without further radiographic imaging. Fifty (39%; 95% CI, 31%-48%) would have been treated without any further laboratory testing or imaging.
  
  
  CONCLUSIONS
  Based on our findings, a future trial of 164 consecutive patients would have 90% power to confirm a 25% reduction in testing and a 25% improvement in decision making.
  
  
  CONCLUSIONS
  Emergency physician-performed ultrasound appears to positively impact decision making and diagnostic workup for patients presenting to the ED with NSAP and should be studied further.
authors: Department of Emergency Medicine, David Geffen School of Medicine at UCLA Harbor-UCLA Medical Center, Torrance, CA 90509. Electronic address: bj@ucla.edu.
authors: Timothy
authors: T
authors: Jang
authors: Division of Emergency Medicine, Department of Surgery, St Louis University School of Medicine, St Louis, MO 63104.
authors: Vijai
authors: V
authors: Chauhan
authors: Division of Emergency Medicine, Department of Surgery, St Louis University School of Medicine, St Louis, MO 63104.
authors: Christopher
authors: C
authors: Cundiff
authors: Department of Emergency Medicine, David Geffen School of Medicine at UCLA Harbor-UCLA Medical Center, Torrance, CA 90509.
authors: Amy H
authors: AH
authors: Kaji
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D000328:Adult; D000465:Algorithms; D003657:Decision Making; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies; D014218:Triage; D014463:Ultrasonography