Ultrasound accuracy similar in community, hospital settings
The accuracy of ultrasound (US) for the detection of urinary calculi is similar between US carried out by hospital sonographers and by independent radiographers and general practitioners (GPs), according to a UK study.
Community US for the diagnosis of urinary calculi may be used more to encourage greater patient/GP satisfaction and to reduce hospital attendance without loss of diagnostic accuracy, researchers said.
All patients (n=2,464) referred to Kent and Canterbury Hospital urology multidisciplinary meeting for suspected urinary calculi were included in a 30-month, single-blind, retrospective cohort study that aimed to test whether there was a significant difference in accuracy between hospital and community-based US.
Included were those investigated with US and noncontrast computer tomography (NCCT, the gold standard) for their calculi. Concordance of US and NCCT was stratified by location: either the hospital or community setting (eg, the latter via GPs or independent radiographers). Researchers used Fisher’s exact test to identify any significant difference between the two patient groups.
Of the total number of patients referred, 257 had both US and NCCT in their diagnostic workup. Of these patients, 150 had their US carried out in hospital and 107 in community settings. There was no significant difference seen in the accuracy of US between the two groups for the detection of urinary calculi when compared with NCCT.
These findings contrasted the study by Chung and colleagues, which found a high discrepancy rate in US reports from the community when compared with US and CT scan reports from the hospital setting. The discordance between community and hospital US imaging studies may be due to the radiologist’s more active role in the hospital setting, according to the researchers. [Can Urol Assoc J 2007;1:251–254]