Abdominal ultrasound referred by the Emergency department – Can sonographer findings help guide timely patient management?

Schneider-Kolsky, Michal Elisabeth; Bloesch, Justin; Lombardo, Paul

doi:10.1016/j.radi.2013.10.010

Cited by 14 publications

(32 citation statements)

References 10 publications

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“…The high accuracy of sonographers’ diagnostic opinion has been documented in numerous studies across all subspecialties with sonographers often demonstrating comparable standard of diagnostic performance to that of radiologists . This raises important questions about the level of oversight that sonographers require by imaging specialists such as radiologists or other sonologists and the required staffing levels and departmental structures.…”

Section: Introductionmentioning

confidence: 99%

Do radiologists need to review abdominal ultrasound examinations reported as ‘normal’ by the sonographer?

Nečas

Shen

Ong

et al. 2020

Australas J Ultrason Med

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Introduction Sonographers demonstrate a high standard of diagnostic performance and work with a considerable degree of professional independence. In Australasia, sonographers typically generate a preliminary report which is reviewed by the radiologist who issues a final report. The aim of this study was to determine whether radiologist's review is required in cases reported as normal by the sonographer. Methods This study was a retrospective review of 1000 abdominal US examinations considered normal by sonographers that were subsequently reported by radiologists. Any findings reported by radiologists that were not reported by sonographers were analysed and separated into errors or discrepancies according to commonly accepted definition. Results The 1000 abdominal examinations included 244 complete abdominal, 200 hepatobiliary, 506 urinary tract and 50 other abdominal examinations. Patients’ age ranged from < 1 to 94 years (mean = 35 years, median = 32 years). US examinations were performed by any one of 14 sonographers with 1–21 years (mean = 6 years, median = 7 years) of clinical experience. Two diagnostic errors were made by sonographers and two errors by radiologists. In no single case did the radiologist uncover a case of an acute or serious illness, illness requiring admission or urgent clinical review, nor did the radiologist identify the cause for the presenting symptoms. Eighteen discrepancies were found, but these were of trivial nature and most were rated by specialist clinicians as irrelevant. Conclusion Sonographers are accurate in distinguishing normal abdominal US examinations. The involvement of a radiologist in a second reading of normal abdominal US examinations is unnecessary.

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Section: Introductionmentioning

confidence: 99%

Do radiologists need to review abdominal ultrasound examinations reported as ‘normal’ by the sonographer?

Nečas

Shen

Ong

et al. 2020

Australas J Ultrason Med

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show abstract

“…3 Previous studies have reported agreement levels for a range of indications including musculoskeletal ultrasound (94.8% agreement), 7 upper abdominal ultrasound (90% agreement), 5 biliary exams (84.5% agreement), 6 non-obstetric ultrasound examinations (94% agreement) 4 and 84.9% agreement in our own previous study in abdominal exams. 3 It is important to note, though, that the reported agreement rates refer to "complete" agreement only and do not take into account minor discrepancies that do not alter patient management. Hence, in practical terms, the reported agreement between sonographer findings and radiologists' reports are probably higher still.…”

Section: Discussionmentioning

confidence: 66%

“…[3][4][5][6][7][8] This includes our own study which demonstrated that sonographers working in a regional hospital in Australia can provide accurate preliminary report for patients referred from the ED for abdominal exams. 3 Previous studies have reported agreement levels for a range of indications including musculoskeletal ultrasound (94.8% agreement), 7 upper abdominal ultrasound (90% agreement), 5 biliary exams (84.5% agreement), 6 non-obstetric ultrasound examinations (94% agreement) 4 and 84.9% agreement in our own previous study in abdominal exams. 3 It is important to note, though, that the reported agreement rates refer to "complete" agreement only and do not take into account minor discrepancies that do not alter patient management.…”

Section: Discussionmentioning

confidence: 99%

“…2 This is of particular concern when patients present to the emergency department (ED) and results are often needed immediately. 3 In the absence of a formal radiologist report, the sonographers' preliminary findings may be used to facilitate appropriate patient management, improve the quality of care and assist in achieving an optimal outcome for the patient, especially for women who present to the ED with pelvic pain which can have serious sequalae requiring immediate surgery in some cases. However, there is to date only little evidence documenting the accuracy of sonographer reporting compared to the reference standard (radiologist report).…”

Section: Introductionmentioning

confidence: 99%

“…Several previous papers have reported high levels of accuracy between the sonographer and radiologists reports for a range of presentations. [3][4][5][6][7] On that basis, formalised sonographer reporting has been successfully developed in other countries such as the United Kingdom; however, they are not recognised in Australia. Given the relatively high number of regional and remote hospitals across Australia, the development and implementation of a sonographer practitioner who can provide formal sonographer reports may improve the ultrasound diagnostic services for patients and referring doctors living too far from metropolitan radiology centres.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pelvic ultrasounds referred from the emergency department: Agreement between sonographer findings and radiologists' reports

Kolsky¹,

Baker²,

Pontonio³

et al. 2020

Sonography

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Introduction: When radiologists are not available, sonographers may be able to provide an interim report, especially for patients referred from emergency or in remote clinics. The aim of this study was to compare the agreement of diagnostic findings between sonographers and radiologists for patients referred from the emergency department for pelvic ultrasound. Methods: Sonographer findings and corresponding radiologists' reports of consecutive pelvic ultrasound examinations referred from the emergency department were compared prospectively over a 7-month period. Paediatric cases were excluded. Diagnostic agreement was scored by an independent investigator into the following: grade 1-agree with radiologist report; grade 2-minor discrepancy, unlikely to impact patient management; grade 3-major discrepancy, likely to impact patient management but does not lead to adverse outcomes for the patient; and grade 4-major discrepancy, findings likely to result in significantly adverse outcome for the patient.

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The clinical ultrasound report: Guideline for sonographers

Nečas

2017

Australas J Ultrason Med

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The reporting roles of sonographers in Australasia vary considerably. A large number of sonographers already routinely produce formal reports, while others are moving into clinical ultrasound roles where reporting is expected. This article summarises the best practice in reporting of ultrasound examinations based on international literature and addresses key topics including report structure, clinical content, style and language. Numerous examples and sample phrases are provided and common pitfalls are discussed.

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Abdominal ultrasound referred by the Emergency department – Can sonographer findings help guide timely patient management?

Cited by 14 publications

References 10 publications

Do radiologists need to review abdominal ultrasound examinations reported as ‘normal’ by the sonographer?

Do radiologists need to review abdominal ultrasound examinations reported as ‘normal’ by the sonographer?

Pelvic ultrasounds referred from the emergency department: Agreement between sonographer findings and radiologists' reports

The clinical ultrasound report: Guideline for sonographers

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