부산대학교 도서관

OBJECTIVES:: Training healthcare physician s to perform intestinal ultrasound (IUS) during outpatient visits with equal accuracy as radiologists could improve clinical management of IBD patients. We aimed to assess whether a healthcare-physician can be trained to perform IUS, with equal accuracy compared to experienced radiologists in children with IBD, and to assess inter-observer agreement. METHODS:: Consecutive children, 6–18 years with IBD or suspicion of IBD, who underwent ileo-colonoscopy were enrolled. IUS was performed independently by a trained healthcare- physician and a radiologist in one visit. Training existed of an international training curriculum for IUS. Operators were blinded for each otherʼs IUS, and for the ileo-colonoscopy. Difference in accuracy of IUS by the healthcare- physician and radiologist was assessed using areas under the ROC-curve (AUROC). Inter-observer variability was assessed in terminal ileum (TI), transverse- (TC) and descending-colon (DC), for disease activity (i.e. bowel wall thickness(BWT)>2 mm with hyperaemia or fat-proliferation, or BWT>3 mm). RESULTS:: We included 73 patients (median age 15, IQR:13–17, 37 (51%) female, 43 (58%) with Crohnʼs Disease). AUROC ranged between 0.71–0.81 for the healthcare- physician and between 0.67–0.79 for radiologist (p > 0.05). Inter-observer agreement for disease activity per segment was moderate (K:0.58 (SE: 0.09), 0.49 (SE: 0.12), 0.52 (SE: 0.11) respectively for TI, TC, and DC). CONCLUSIONS:: A healthcare- physician can be trained to perform IUS in children with IBD with comparable diagnostic accuracy as experienced radiologists. The inter-observer agreement is moderate. Our findings support the usage of IUS in clinical management of children with IBD.