Degree of Uncertainty in Reporting Imaging Findings for Necrotizing Enterocolitis: A Secondary Analysis from a Pilot Randomized Diagnostic Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Setting
2.3. Determination of Uncertainty
2.4. Outcomes and Variables of Interest
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Imaging Modality | Template |
---|---|
AXR | There are no findings to suggest bowel obstruction, free intraperitoneal gas, or pneumatosis. |
There is no portal venous gas. | |
BUS | There is no bowel wall thickening (>2.7 mm). |
There is no bowel wall thinning (<1.0 mm). | |
There is no bowel wall hyperechogenicity. | |
There is no pneumatosis intestinalis. | |
There is no portal venous gas. | |
There is no pneumoperitoneum. | |
There are no focal fluid collections with complex echoes. | |
There is no free fluid. | |
There is normal bowel wall perfusion. | |
Peristalsis is present. |
Score | Degree of Uncertainty | Example |
---|---|---|
1 | Lowest level of uncertainty. No equivocation. | No pneumatosis. |
No portal venous gas. | ||
No pneumoperitoneum. | ||
2 | Low level of uncertainty. Minimal equivocation. | No definite pneumatosis. |
No supine evidence of pneumoperitoneum. | ||
No obvious free air. | ||
3 | Intermediate level of uncertainty. Intermediate degree of equivocation. | No findings to suggest pneumatosis, portal venous gas, or free air. |
Small area of possible linear lucency along the bowel wall. | ||
Suggestion of interim mural air within the bowel wall. | ||
4 | Highest level of uncertainty. High degree of equivocation. | Cannot exclude pneumatosis. |
No obvious pneumatosis although evaluation is limited. | ||
Mild mottled lucencies which may represent pneumatosis or stool. |
Baseline Characteristics | AXR Group (n = 8) | AXR Plus BUS Group (n = 8) |
---|---|---|
Gestational age, weeks | 26.9 ± 2.5 | 27.4 ± 2.1 |
Birth weight, grams | 1056 ± 399 | 1022 ± 381 |
Male sex, no. (%) | 5 (63) | 2 (25) |
White race, no. (%) | 4 (50) | 6 (75) |
Small for gestational age, no. (%) | 0 (0) | 1 (13) |
Maternal age, years a | 25 ± 7 | 31 ± 7 |
Caesarian delivery, no. (%) | 3 (38) | 5 (63) |
Apgar score < 5 at 1 min, no. (%) b | 4 (50) | 7 (88) |
Apgar score < 5 at 5 min, no. (%) b | 3 (38) | 2 (25) |
Antenatal corticosteroids, no. (%) | 8 (100) | 7 (88) |
Surfactant, no. (%) | 8 (100) | 6 (75) |
No. of NEC concern episodes | 1 (1–3) | 1 (1–3) |
No. of imaging studies | ||
AXR | 49 | 64 |
BUS | 0 | 24 |
BUS n = 24 | AXR n = 113 | p | |
---|---|---|---|
Complete report, n (%) | 23 (96) | 59 (52) | 0.0001 |
Pneumatosis | 24 (100) | 111 (98) | 1.0 |
Portal venous gas | 24 (100) | 67 (59) | 0.0001 |
Free air | 23 (96) | 95 (84) | 0.19 |
Use of standardized template, n (%) | 21 (88) | 18 (16) | 0.0001 |
AXR + BUS Arm n = 64 | AXR Arm n = 49 | p | |
---|---|---|---|
Complete report, n (%) | 35 (55) | 24 (49) | 0.55 |
Pneumatosis | 63 (98) | 48 (98) | 1.0 |
Portal venous gas | 42 (66) | 25 (51) | 0.12 |
Free Air | 54 (84) | 41 (84) | 0.92 |
Use of standardized template, n (%) | 9 (14) | 9 (18) | 0.54 |
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Cuna, A.; Rathore, D.; Bourret, K.; Opfer, E.; Chan, S. Degree of Uncertainty in Reporting Imaging Findings for Necrotizing Enterocolitis: A Secondary Analysis from a Pilot Randomized Diagnostic Trial. Healthcare 2024, 12, 511. https://doi.org/10.3390/healthcare12050511
Cuna A, Rathore D, Bourret K, Opfer E, Chan S. Degree of Uncertainty in Reporting Imaging Findings for Necrotizing Enterocolitis: A Secondary Analysis from a Pilot Randomized Diagnostic Trial. Healthcare. 2024; 12(5):511. https://doi.org/10.3390/healthcare12050511
Chicago/Turabian StyleCuna, Alain, Disa Rathore, Kira Bourret, Erin Opfer, and Sherwin Chan. 2024. "Degree of Uncertainty in Reporting Imaging Findings for Necrotizing Enterocolitis: A Secondary Analysis from a Pilot Randomized Diagnostic Trial" Healthcare 12, no. 5: 511. https://doi.org/10.3390/healthcare12050511