T C Rosenthal1, T Siepel, J Zubler, M Horwitz. 1. Department of Family Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo 14215.
Abstract
BACKGROUND: Ultrasonography has become an increasingly important diagnostic tool, producing high-quality images at a low cost. However, except in obstetrics, ultrasonography has not been used for screening purposes in asymptomatic persons. METHODS: This prospective study included 189 patients on whom an abdominal ultrasound scan was performed by a family physician as part of a routine physical examination. During the 2-year follow-up period, the screening was evaluated by determining whether the ultrasound findings contributed to the patient's health care management. RESULTS: Forty-two of the patients (22%) were found to have previously undiagnosed conditions. The most common findings were gallstones, urinary retention, and renal cysts. Six patients (3%) received treatment for the condition detected by the screening, but three of these patients received treatment only after they developed symptoms during the 2-year follow-up period. One patient developed symptoms for gallstones that may have been missed by the screening ultrasound. The internal and external reliability rates for the screening examination were 96% and 82%, respectively. CONCLUSIONS: Ultrasound findings altered the treatment plan for 3% of the screened patients but was the sole factor leading to treatment in only 1.6%. Abdominal ultrasound can be performed accurately and at a reasonable cost by generalist physicians. Patient acceptance was high, and many reported feeling reassured by the ultrasound screening.
BACKGROUND: Ultrasonography has become an increasingly important diagnostic tool, producing high-quality images at a low cost. However, except in obstetrics, ultrasonography has not been used for screening purposes in asymptomatic persons. METHODS: This prospective study included 189 patients on whom an abdominal ultrasound scan was performed by a family physician as part of a routine physical examination. During the 2-year follow-up period, the screening was evaluated by determining whether the ultrasound findings contributed to the patient's health care management. RESULTS: Forty-two of the patients (22%) were found to have previously undiagnosed conditions. The most common findings were gallstones, urinary retention, and renal cysts. Six patients (3%) received treatment for the condition detected by the screening, but three of these patients received treatment only after they developed symptoms during the 2-year follow-up period. One patient developed symptoms for gallstones that may have been missed by the screening ultrasound. The internal and external reliability rates for the screening examination were 96% and 82%, respectively. CONCLUSIONS: Ultrasound findings altered the treatment plan for 3% of the screened patients but was the sole factor leading to treatment in only 1.6%. Abdominal ultrasound can be performed accurately and at a reasonable cost by generalist physicians. Patient acceptance was high, and many reported feeling reassured by the ultrasound screening.
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