Point-of-Care Ultrasound by Nonexpert Operators Demonstrates High Sensitivity and Specificity in Detecting Gallstones: Data from the Samoa Typhoid Fever Control Program.
Point-of-Care Ultrasound by Nonexpert Operators Demonstrates High Sensitivity and Specificity in Detecting Gallstones: Data from the Samoa Typhoid Fever Control Program.
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NOTXPERT操作员的即将到来的超声检查表现出高灵敏度和特异性检测胆结石：Samoa伤寒控制程序的数据。
DOI：
10.4269/ajtmh.21-0973
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发表时间：
2022-01-10
期刊：
影响因子：
--
通讯作者：
Levine MM
中科院分区：
文献类型：
--
作者：
Hoffman SA;Desai SN;Sikorski MJ;Fatupaito G;Tupua S;Thomsen RE;Rambocus S;Nimarota-Brown S;Punimata LL;Sialeipata M;Tuilagi CF;Han J;Robins-Browne RM;Naseri TK;Levine MM
大约90%的慢性伤寒携带者与持续性沙门氏菌伤寒血清型（S。伤寒）胆囊感染有胆结石。在萨摩亚，伤寒已流行了几十年，成年人中诱发胆结石的风险因素正在增加。萨摩亚伤寒控制方案派遣了一个“伤寒流行病学特警队”，对每一个经血培养确诊的急性伤寒病例进行家庭调查。调查包括筛查家庭接触者，以发现慢性携带者。经过有限的培训，两名非专业超声操作员于2019年8月至9月对120名萨摩亚成年人进行了床旁超声（POCUS），以探索POCUS在家庭调查和社区筛查期间检测胆结石患者的可行性。来自三个队列（28名食品处理人员，两名伤寒病例及其18名家庭接触者，以及72名门诊就诊者）的120名萨摩亚成年人的POCUS扫描由一名委员会认证的放射科医生进行审查，该放射科医生认为96/120（80%）的扫描是可解释的。与放射科医生（金标准）相比，非专家操作员成功检测到6/7名萨摩亚人胆结石（85.7%的灵敏度），并正确识别85/89名无胆结石（95.5%的特异性）。该试点中使用最低限度培训的临床医生（既不是放射科医生也不是超声技术人员）的不可解释扫描的比例（24/120）表明需要对POCUS操作员进行额外培训。尽管如此，这项试点可行性研究还是带来了乐观，即在萨摩亚环境中，非专家可以接受POCUS诊断胆石症的培训，从而有助于（沿着粪便培养和Vi血清学）识别可能的慢性S。伤寒携带者。
Approximately 90% of chronic typhoid carriers with persistent Salmonella enterica serovar Typhi (S. Typhi) gallbladder infection have gallstones. In Samoa, where typhoid fever has been endemic for many decades, risk factors predisposing to the development of gallstones are increasing among adults. The Samoa Typhoid Fever Control Program dispatches a “Typhoid Epidemiologic SWAT Team” to perform a household investigation of every blood culture-confirmed case of acute typhoid fever. Investigations include screening household contacts to detect chronic carriers. Following limited training, two nonexpert ultrasound operators performed point-of-care ultrasound (POCUS) on 120 Samoan adults from August to September 2019 to explore the feasibility of POCUS to detect individuals with gallstones during household investigations and community screenings. POCUS scans from 120 Samoan adults in three cohorts (28 food handlers, two typhoid cases and their 18 household contacts, and 72 attendees at an ambulatory clinic) were reviewed by a board-certified radiologist who deemed 96/120 scans (80%) to be interpretable. Compared with the radiologist (gold standard), the nonexpert operators successfully detected 6/7 Samoans with gallstones (85.7% sensitivity) and correctly identified 85/89 without gallstones (95.5% specificity). The proportion (24/120) of uninterpretable scans from this pilot that used minimally trained clinicians (who are neither radiologists nor ultrasound technicians) indicates the need for additional training of POCUS operators. Nevertheless, this pilot feasibility study engenders optimism that in the Samoan setting nonexperts can be trained to use POCUS to diagnose cholelithiasis, thereby helping (along with stool cultures and Vi serology) to identify possible chronic S. Typhi carriers.
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影响因子：
5.5
作者：
Vadrevu, Krishna Mohan;Raju, Dugyala;Levine, Myron M.
通讯作者：
Levine, Myron M.
影响因子：
5.4
作者：
Ezeamama, Amara E.;Viali, Satupaitea;McGarvey, Stephen T.
通讯作者：
McGarvey, Stephen T.
DOI：
10.1017/cbo9780511542510.008
发表时间：
2007-01-01
期刊：
HEALTH CHANGE IN THE ASIA-PACIFIC REGION: BIOCULTURAL AND EPIDEMIOLOGICAL APPROACHES
影响因子：
--
作者：
Keighley, Ember D.;McGarvey, Stephen T.;Maga, Uto'ofili A.
通讯作者：
Maga, Uto'ofili A.
影响因子：
158.5
作者：
Shakya, Mila;Colin-Jones, Rachel;Pollard, Andrew J.
通讯作者：
Pollard, Andrew J.
影响因子：
2.9
作者：
Keighley, ED;McGarvey, ST;Vial, S
通讯作者：
Vial, S