{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T21:49:21Z","timestamp":1771019361230,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,5,28]],"date-time":"2018-05-28T00:00:00Z","timestamp":1527465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to evaluate the ability of emergency physicians with various levels of point\u2010of\u2010care ultrasound (<jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content>) experience to detect appendicitis with <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> among children visiting a pediatric emergency department (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study was conducted in an urban, tertiary care pediatric <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>. Children aged 2 to 18 years old who presented with acute abdominal pain suggesting appendicitis were included. Patients were excluded if they had a history of appendectomy or hemodynamic instability requiring resuscitation or were transferred with proven diagnosis of appendicitis. Participating physicians had various levels of <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> experience. Four of the 22 physicians were experienced in bowel sonography while the others had basic experience in abdominal <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content>. All the participating physicians received a 1\u2010hour didactic and practical training session on appendix ultrasound. The treating physician performed <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> following initial physical examination, before further radiologic evaluation. <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> examinations were recorded as positive for appendicitis, normal, or inconclusive, with normal or inconclusive studies considered negative. Final outcomes were determined by pathology and\/or operative reports for surgical cases and telephone follow\u2010up at 3 weeks for those who did not have surgery. The primary analysis was a simple proportion for sensitivity and specificity for <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content>. Expecting a sensitivity of 80% based on previous studies, we calculated that a sample size of 50 cases would provide a 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) ranging from 66% to 90%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 140 approached patients, 121 accepted to participate and were recruited. After four patients were excluded for missing <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> data, 117 patients were included in the primary analysis, of whom 51 (44%) had appendicitis. Twenty\u2010two physicians performed between one and 20 <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> procedures. The <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> was positive in 39, negative in nine, and inconclusive in 69 patients. <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> was interpreted as positive in 27 of 51 appendicitis for a sensitivity of 0.53 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0= 0.40\u20130.66). A negative or inconclusive <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> was reported for 54 of 66 patients without appendicitis (specificity\u00a0= 0.82; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0= 0.71\u20130.89).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study shows limited sensitivity and specificity of <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content> for appendicitis in children, with a high proportion of inconclusive examinations, when performed by emergency physicians with various level of experience in <jats:styled-content style=\"fixed-case\">POCUS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13445","type":"journal-article","created":{"date-parts":[[2018,5,8]],"date-time":"2018-05-08T13:50:40Z","timestamp":1525787440000},"page":"1035-1041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Bedside Sonography Performed by Emergency Physicians to Detect Appendicitis in Children"],"prefix":"10.1111","volume":"25","author":[{"given":"Marie","family":"Nicole","sequence":"first","affiliation":[{"name":"Emergency Department H\u00f4pital du Sacr\u00e9\u2010Coeur de Montr\u00e9al Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Pier","family":"Desjardins","sequence":"additional","affiliation":[{"name":"Emergency Department CHU Ste\u2010Justine Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn","family":"Gravel","sequence":"additional","affiliation":[{"name":"Emergency Department CHU Ste\u2010Justine Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.4.438"},{"key":"e_1_2_7_3_1","first-page":"263","article-title":"Epidemiologic features of acute appendicitis in Ontario. 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