title: Comparison of the accuracy and reproducibility of focused abdominal sonography for trauma performed by emergency medicine and radiology residents.
abstract: We compared the diagnostic accuracy of emergency medicine residents (EMRs) and radiology residents (RRs) in performing focused abdominal sonography for trauma (FAST). The cohort in this prospective study comprised 200 unstable patients (163 males and 37 females; mean ± standard deviation of age, 34.3 ± 16.4 y) who presented with trauma. These patients were evaluated using FAST, first by EMRs and subsequently by RRs. Patients with positive FAST results underwent further diagnostic procedures such as computed tomography, diagnostic peritoneal lavage and laparotomy. Those with negative FAST results underwent clinical follow-up for 72 h until their condition deteriorated or they were discharged. Sensitivity, specificity, positive and negative predictive values and accuracy in evaluating free intraperitoneal fluid were 80%, 95%, 57%, 98% and 94% when FAST was performed by EMRs and 86%, 95%, 59%, 98% and 94% when FAST was performed by RRs. The level of agreement between EMRs and RRs was moderate (κ = 0.525). FAST is a useful screening tool for initial assessment of free abdominal fluid in patients with trauma. Our results indicate that EMRs can perform sonography on trauma patients as successfully as RRs.
authors.affiliation: Imam Hossein Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Arhami Dolatabadi
authors.affiliation: Imam Hossein Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Amini
authors.affiliation: Safety Promotion & Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Hatamabadi
authors.affiliation: Haft-e-Tir Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Mohammadi
authors.affiliation: Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Faghihi-Kashani
authors.affiliation: Imam Hossein Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hojjat
authors.initials: H
authors.lastname: Derakhshanfar
authors.affiliation: Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Morteza
authors.initials: SM
authors.lastname: Tabatabaee
authors.affiliation: Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Moghimi
authors.affiliation: Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: aikabir@yahoo.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Kabir
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000193:education / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007492:Iran; D008297:Male; D008875:Middle Aged; D011871:Radiology / Q000193:education / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000706:statistics & numerical data
keywords: Abdominal injuries; Computed tomography; Emergency medicine; Radiology; Ultrasonography