[Abdominal ultrasound: a diagnostic tool within the reach of general practitioners].

AIM

To assess the impact of training two general practitioners (GPs), on performing low complexity ultrasound examinations of the abdomen with diagnostic competence.

STUDY DESIGN

A non-randomised, prospective, double blind evaluation study of the acquired competence. Ultrasound examinations were performed successively and independently by the GP and the radiologist, and registered on two sheets of an identical case report form.

SETTING

Departments of Vic General Hospital and Vic Health Care Centre of the Catalan Health Institute.

SUBJECTS

A total of 120 patients who needed a low complexity abdominal ultrasound from a total amount of 868 ultrasound examinations scheduled.

MAIN MEASUREMENTS

The kappa index of the primary diagnosis (ultrasound diagnostic conclusion), as well as of the ultrasound findings for each abdominal organ was calculated. A good level of training was considered if a minimum kappa index of 0.80 was attained between general practitioner and radiologist.

RESULTS

After six month running, an "ad interim" analysis showed a kappa index for the primary ultrasound diagnosis of 0.85. At the end of the study, an overall kappa index of 0.89 (95% CI: 0.82-0.98) was achieved. The agreement by organs was also high (pancreas and spleen excluded), as well as sensitivity (>75%) and specificity (>90%).

CONCLUSIONS

The results of the study demonstrate the feasibility of the performance, by trained GPs, of ultrasound examinations of low complexity of the abdomen with diagnostic competence.