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J Korean Soc Emerg Med > Volume 20(5); 2009 > Article
Journal of The Korean Society of Emergency Medicine 2009;20(5): 546-554.
The Effectiveness of Transvaginal Ultrasonography Performed by Emergency Physicians
Si Young Jung, Hyun Noh, Koo Young Jung, Eun Kyung Eo
1Department of Emergency Medicine, School of medicine, Ewha Womans University, Seoul, Korea. liz0803@ewha.ac.kr
2Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Korea.
The aim of this study was to examine the diagnostic accuracy and effectiveness of transvaginal ultrasonography (TVUS) performed by emergency physicians (EPs') in the emergency department.
In this study, female patients with lower abdominal pain who had risks for obstetric and gynecologic diseases were assessed. The accuracy and effectiveness of TVUS performed by emergency physicians was determined by comparing EPs' interpretations of TVUS with the interpretations of TVUS by OGs CT findings, and surgical pathologic results.
Forty-one patients were included in the study. The diagnosis was changed in 48.8% of the patients after the TVUS had been performed by an EPs'. When the accuracy of diagnosis was compared pre- and post-TVUS, the accuracy of post-TVUS (80.5%) was higher than the pre-TVUS (39.0%). The agreement between the sonographic findings of EPs' and OGs' was substantial (accuracy=81.3~93.8%; kappa=0.611~0.811; p<0.05). The accuracy of TVUS performed by EPs' in obstetric and gynecologic diseases was 90.6%. The sensitivity and specificity were 100% and 90.9%, respectively, and the positive and negative predictive values were 96.8% and 100%, respectively.
TVUS performed by EPs' is of considerable help in establishing the correct diagnosis with a high degree of accuracy.
Key words: Ultrasonography, Vagina, Adominal pain, Emergency medicine, Differential diagnosis
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