Brakel J W, Berendsen T A, Callenbach P M C, van der Burgh J, Hissink R J, van den Berg M
Department of Surgery, Treant Zorggroep, Boermarkeweg 60, 7824 AA, Emmen, Netherlands.
Ultrasound J. 2020 Nov 11;12(1):46. doi: 10.1186/s13089-020-00192-5.
Several countries advocate screening for aneurysms of the abdominal aorta (AAA) in selected patients. In the Netherlands, routine screening is currently under review by the National Health Council. In any screening programme, cost-efficiency and accuracy are key. In this study, we evaluate the Aorta Scan (Verathon, Amsterdam, Netherlands), a cost-effective and easy-to-use screening device based on bladder scan technology, which enables untrained personnel to screen for AAA.
We subjected 117 patients to an Aorta Scan and compared the results to the gold standard (abdominal ultrasound). We used statistical analysis to determine sensitivity and specificity of the Aorta Scan, as well as the positive and negative predictive values, accuracy, and inter-test agreement (Kappa).
Sensitivity and specificity were 0.86 and 0.98, respectively. Positive predictive value was 0.98 and negative predictive value was 0.88. Accuracy was determined at 0.92 and the Kappa value was 0.85. When waist-hip circumferences (WHC) of > 115 cm were excluded, sensitivity raised to 0.96, specificity stayed 0.98, positive and negative predictive value were 0.98 and 0.96, respectively, accuracy to 0.97, and Kappa to 0.94.
Herein, we show that the Aorta Scan is a cost-effective and very accurate screening tool, especially in patients with WHC below 115 cm, which makes it a suitable candidate for implementation into clinical practice, specifically in the setting of screening selected populations for the presence of AAA.
几个国家提倡对特定患者进行腹主动脉瘤(AAA)筛查。在荷兰,国家卫生委员会目前正在审查常规筛查。在任何筛查计划中,成本效益和准确性都是关键。在本研究中,我们评估了主动脉扫描(Verathon,阿姆斯特丹,荷兰),这是一种基于膀胱扫描技术的经济高效且易于使用的筛查设备,使未经培训的人员能够筛查AAA。
我们对117名患者进行了主动脉扫描,并将结果与金标准(腹部超声)进行比较。我们使用统计分析来确定主动脉扫描的敏感性和特异性,以及阳性和阴性预测值、准确性和检验间一致性(Kappa)。
敏感性和特异性分别为0.86和0.98。阳性预测值为0.98,阴性预测值为0.88。准确性确定为0.92,Kappa值为0.85。当排除腰臀围(WHC)>115 cm的患者时,敏感性提高到0.96,特异性保持在0.98,阳性和阴性预测值分别为0.98和0.96,准确性为0.97,Kappa为0.94。
在此,我们表明主动脉扫描是一种经济高效且非常准确的筛查工具,特别是在WHC低于115 cm的患者中,这使其成为临床实践中实施的合适候选者,特别是在筛查特定人群是否存在AAA的情况下。