The Role of Abdominal Radiography in the Diagnosis of Intussusception When Interpreted by Pediatric Emergency Physicians
Received 16 December 2008; received in revised form 12 February 2009; accepted 5 April 2009. published online 29 June 2009.
Objective
To evaluate the sensitivity and specificity of abdominal x-rays in the diagnosis of intussusception when interpreted by pediatric emergency physicians.
Study design
This was a prospective experimental study. Participants were board-certified/eligible pediatric emergency physicians. They evaluated a module containing radiographs of 50 cases of intussusception and 50 controls, matched for age and sex. For each x-ray, the physicians stated whether the x-ray increased, decreased or did not affect suspicion of intussusception. The primary outcome was the percentage of cases for which physicians stated that the x-ray increased their level of suspicion (sensitivity). Secondary outcomes included the proportion of false-negative results and specificity.
Results
Fourteen of 15 eligible physicians participated in the study. Overall, abdominal radiography increased the index of suspicion of intussusception in 48% of cases (sensitivity) and 21% of controls; however, in 11% of cases, the abdominal x-rays were incorrectly interpreted as being reassuring. The specificity was 21%. The radiographs were deemed equivocal for 41% of cases and 58% of controls.
Conclusions
Abdominal x-rays have a low sensitivity and specificity for diagnosing intussusception when interpreted by pediatric emergency physicians.
ABSTRACT