title: Evaluation of the accuracy of aorta scan BVI 9600 in screening for abdominal aortic aneurysm.
abstract: OBJECTIVE
  Despite a decreasing incidence of abdominal aortic aneurysm (AAA), the cost-effectiveness of AAA ultrasound screening can be improved by reducing the screening costs and increasing the uptake rates. The BVI 9600 (BVI) is a promising tool for this purpose as it is inexpensive and can detect AAA without a trained operator. This study aims to investigate whether the BVI can be used to detect AAA for the purpose of a low-cost outreach screening approach.
  
  
  METHODS
  A total of 142 subjects had their abdominal aortae measured by five sonographers using the BVI and a conventional ultrasound machine. The examination included four anterior-posterior measurements at four equally spaced scanning locations from the xiphisternum to the umbilicus. The measurements produced by each machine were compared using Bland-Altman plots, followed by an analysis of the AAA detection performance.
  
  
  RESULTS
  The BVI measured the aortic diameter to within 0.88-1.56 cm of the true diameter, exceeding the 0.5 cm "clinically acceptable difference" (CAD). Its accuracy was poorer when measuring the aneurysmal aortae (mean difference -0.56 cm, variability 1.72 cm) than normal aortae (mean difference 0.02 cm, variability 0.76 cm). Nine out of 52 aneurysms were not detected due to undersizing measurement and non-visualization of the aortae.
  
  
  CONCLUSIONS
  At present, the BVI is not sufficiently accurate to detect AAA for screening purposes. A number of technical features require improvement.
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: A T V
authors.initials: AT
authors.lastname: Nguyen
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: G B
authors.initials: GB
authors.lastname: Hill
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: I A
authors.initials: IA
authors.lastname: Thomson
authors.affiliation: Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Electronic address: andre.vanrij@otago.ac.nz.
authors.forename: A M
authors.initials: AM
authors.lastname: van Rij
mesh_terms: D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D004108:Dilatation, Pathologic; D004867:Equipment Design; D006801:Humans; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014463:Ultrasonography
keywords: Aortic aneurysm; Screening; Ultrasound