Zangerle K F, Iserson K V, Bjelland J C, Criss E
Ann Emerg Med. 1985 Apr;14(4):316-9. doi: 10.1016/s0196-0644(85)80095-0.
A total of 120 plain abdominal radiographs (PARs) from intravenous pyelograms (IVPs) were presented without patient history in a random manner to a staff radiologist and staff emergency physician (EP). Scout films were used as the PAR to minimize calculus movement. Each reader examined each film for the presence of ureteral calculi. The readers localized all calculi and rated the likelihood of their presence. Fifty-one PARs from IVPs demonstrated ureteral calculus disease; 40 of these films demonstrated 41 radiopaque calculi, while 11 films demonstrated obstruction without radiopaque calculi. These readings were then matched to the known IVP results. Together the readers were correct on 50% of the predictions (radiologist, 51%; EP, 48%). The EP and the radiologist had similarly correct percentages on PARs from positive IVPs (33% and 36%, respectively) and on PARs from negative IVPs (60% and 64%). True-positive (33% and 25%), true-negative (76% and 71%), false-positive (27% and 35%), and false-negative (36% and 55%) rates were constructed for the radiologist and EP, respectively. Our study demonstrates that PARs are unreliable and do not appear to add useful information in the evaluation of suspected ureteral colic.
从静脉肾盂造影（IVP）中随机选取120张腹部平片（PAR），在未提供患者病史的情况下，分别交给一名放射科工作人员和一名急诊内科医生（EP）。使用定位片作为PAR，以尽量减少结石移动。每位阅片者检查每张片子是否存在输尿管结石。阅片者对所有结石进行定位，并对其存在的可能性进行评级。IVP的51张PAR显示有输尿管结石病；其中40张片子显示有41个不透X线的结石，而11张片子显示有梗阻但无不透X线的结石。然后将这些阅片结果与已知的IVP结果进行比对。阅片者总体预测正确率为50%（放射科医生为51%，急诊内科医生为48%）。急诊内科医生和放射科医生对阳性IVP的PAR（分别为33%和36%）以及阴性IVP的PAR（分别为60%和64%）的正确百分比相似。分别为放射科医生和急诊内科医生构建了真阳性率（分别为33%和25%）、真阴性率（分别为76%和71%）、假阳性率（分别为27%和35%）以及假阴性率（分别为36%和55%）。我们的研究表明，PAR不可靠，在评估疑似输尿管绞痛时似乎并未增加有用信息。
