Abstract：
OBJECTIVE: To investigate the accuracy of point-of-care ultrasound (PoCUS) in diagnosing acute appendicitis in children; to evaluate the concordance between PoCUS performed by a pediatric emergency physician (PedEm) and ultrasonography (US) performed by a radiologist; to draw a \"learning curve.\"
METHODS: We prospectively enrolled children aged 0-14 years old led to the Emergency Department of Regina Margherita Children\'s Hospital, from January 2021 to June 2021, with suspected acute appendicitis. PoCUS was performed by a single trained PedEm, blindly to the radiologist\'s scan. A \"self-assessment score\" and the \"time of duration of PoCUS\" were recorded for each patient. Final diagnosis of appendicitis was made by a pediatric surgeon.
RESULTS: We enrolled 62 children (2-14 years). Overall sensitivity of PoCUS was 88%, specificity 90%; PPV 90.6%, and NPV 86.6%. Global concordance between the PedEm and the radiologist was good/excellent (k 0.74). The mean duration of PoCUS significantly decreased during the study period, while the self-assessment score increased.
CONCLUSIONS: This is a preliminary study that shows the effectiveness of PoCUS in diagnosing acute appendicitis; furthermore, it shows how the PedEm\'s performance may improve over time. The learning curve showed how the experience of the PedEm affects the accuracy of PoCUS.
METHODS: We prospectively enrolled children aged 0-14 years old led to the Emergency Department of Regina Margherita Children\'s Hospital, from January 2021 to June 2021, with suspected acute appendicitis. PoCUS was performed by a single trained PedEm, blindly to the radiologist\'s scan. A \"self-assessment score\" and the \"time of duration of PoCUS\" were recorded for each patient. Final diagnosis of appendicitis was made by a pediatric surgeon.
RESULTS: We enrolled 62 children (2-14 years). Overall sensitivity of PoCUS was 88%, specificity 90%; PPV 90.6%, and NPV 86.6%. Global concordance between the PedEm and the radiologist was good/excellent (k 0.74). The mean duration of PoCUS significantly decreased during the study period, while the self-assessment score increased.
CONCLUSIONS: This is a preliminary study that shows the effectiveness of PoCUS in diagnosing acute appendicitis; furthermore, it shows how the PedEm\'s performance may improve over time. The learning curve showed how the experience of the PedEm affects the accuracy of PoCUS.
摘要：
目的：探讨定点照护超声（PoCUS）诊断儿童急性阑尾炎的准确性；评估儿科急诊医师（PedEm）进行的PoCUS与放射科医师进行的超声检查（US）之间的一致性；绘制学习曲线。\"
方法：我们前瞻性地招募了0-14岁的儿童，导致里贾纳·玛格丽特儿童医院急诊科，2021年1月至2021年6月，疑似急性阑尾炎。PoCUS由一个受过训练的PedEm执行，盲目地接受放射科医生的扫描。记录每位患者的“自我评估评分”和“PoCUS持续时间”。阑尾炎的最终诊断是由儿科外科医生做出的。
结果：我们招募了62名儿童（2-14岁）。PoCUS的总体灵敏度为88%,特异性90%；PPV90.6%，和净现值86.6%。PedEm和放射科医师之间的整体一致性良好/优异(k0.74)。在研究期间，PoCUS的平均持续时间显着减少，而自我评估得分增加。
结论：这是一项初步研究，显示了PoCUS诊断急性阑尾炎的有效性；此外，它显示了PedEm的性能如何随着时间的推移而提高。学习曲线显示了PedEm的经验如何影响PoCUS的准确性。
方法：我们前瞻性地招募了0-14岁的儿童，导致里贾纳·玛格丽特儿童医院急诊科，2021年1月至2021年6月，疑似急性阑尾炎。PoCUS由一个受过训练的PedEm执行，盲目地接受放射科医生的扫描。记录每位患者的“自我评估评分”和“PoCUS持续时间”。阑尾炎的最终诊断是由儿科外科医生做出的。
结果：我们招募了62名儿童（2-14岁）。PoCUS的总体灵敏度为88%,特异性90%；PPV90.6%，和净现值86.6%。PedEm和放射科医师之间的整体一致性良好/优异(k0.74)。在研究期间，PoCUS的平均持续时间显着减少，而自我评估得分增加。
结论：这是一项初步研究，显示了PoCUS诊断急性阑尾炎的有效性；此外，它显示了PedEm的性能如何随着时间的推移而提高。学习曲线显示了PedEm的经验如何影响PoCUS的准确性。
