Lanoix R, Baker W E, Mele J M, Dharmarajan L
Department of Emergency Medicine, New York Medical College, Lincoln Medical and Mental Health Center, Bronx, NY, USA.
Acad Emerg Med. 1998 Jan;5(1):58-63. doi: 10.1111/j.1553-2712.1998.tb02576.x.
To evaluate a 4-hour ultrasonography course in the setting of an emergency medicine (EM) training program.
EM residents and faculty at a large urban center were provided a 4-hour emergency ultrasonography course. Then, during an 18-month period, a nonconsecutive sample of ultrasonographic examinations were videotaped and later reviewed. The interpretations of the emergency, physician examinations were compared with the following reference standards: 1) an official ultrasound performed and interpreted by the departments of radiology or cardiology; 2) an operative report; 3) A CT scan or i.v. pyelogram (IVP); or 4) a cardiologist's or a radiologist's interpretation of the videotaped examinations.
Of 258 examinations reviewed, 28 (11%) of these were excluded because the cardiologist or radiologist reviewing the videotape determined them to be "technically limited" studies. Of the remaining 230 examinations, there were: 127 gallbladder studies [disease prevalence = 0.58; sensitivity = 0.89; specificity = 0.80; kappa (kappa) = 0.69; 95% CI: 56-82%]; 39 echocardiograms to rule out pericardial effusions [disease prevalence = 0.15; sensitivity = 0.83; specificity = 0.97 kappa = 0.80; 95% CI: 54-100%]; 25 abdominal ultrasounds to rule out free peritoneal fluid [disease prevalence = 0.32; sensitivity = 0.88; specificity = 0.94; kappa = 0.81; 95% CI: 26-95%]; 16 renal ultrasounds to rule out hydronephrosis [disease prevalence = 0.25; sensitivity = 1.0; specificity = 0.92; kappa = 0.84; 95% CI: 56-100%]; 12 pelvic ultrasounds to rule in an intrauterine pregnancy [disease prevalence = 0.67; sensitivity = 1.0; specificity = 0.75; kappa = 0.80; 95% CI: 43-100%]; and 11 abdominal ultrasounds to rule out abdominal aortic aneurysms [disease prevalence = 0.09; sensitivity = 1.0; 95% CI: 2.5-91%; specificity = 1.0; 95% CI: 68-100%].
This 4-hour ultrasonography course has potential to serve as a foundation for an instructional model for ultrasonography training in the setting of an EM residency program.
评估在急诊医学（EM）培训项目中开展的为期4小时的超声检查课程。
为一个大型城市中心的急诊医学住院医师和教员提供了为期4小时的急诊超声检查课程。然后，在18个月的时间里，对一系列非连续的超声检查进行录像，并随后进行回顾。将急诊医生的检查结果解释与以下参考标准进行比较：1）由放射科或心脏病科进行并解释的正式超声检查；2）手术报告；3）CT扫描或静脉肾盂造影（IVP）；或4）心脏病专家或放射科专家对录像检查的解释。
在审查的258项检查中，有28项（11%）被排除，因为审查录像的心脏病专家或放射科专家认为它们是“技术受限”的研究。在其余230项检查中，有：127项胆囊研究[疾病患病率 = 0.58；敏感性 = 0.89；特异性 = 0.80；kappa（κ）= 0.69；95%置信区间：56 - 82%]；39项用于排除心包积液的超声心动图[疾病患病率 = 0.15；敏感性 = 0.83；特异性 = 0.97；kappa = 0.80；95%置信区间：54 - 100%]；25项用于排除腹腔游离液体的腹部超声检查[疾病患病率 = 0.32；敏感性 = 0.88；特异性 = 0.94；kappa = 0.81；95%置信区间：26 - 95%]；16项用于排除肾积水的肾脏超声检查[疾病患病率 = 0.25；敏感性 = 1.0；特异性 = 0.92；kappa = 0.84；95%置信区间：56 - 100%]；12项用于确定宫内妊娠的盆腔超声检查[疾病患病率 = 0.67；敏感性 = 1.0；特异性 = 0.75；kappa = 0.80；95%置信区间：43 - 100%]；以及11项用于排除腹主动脉瘤的腹部超声检查[疾病患病率 = 0.09；敏感性 = 1.0；95%置信区间：2.5 - 91%；特异性 = 1.0；95%置信区间：68 - 100%]。
这门为期4小时的超声检查课程有潜力作为急诊医学住院医师培训项目中超声检查培训教学模式的基础。
