208 Evaluation of Emergency Ultrasound Literature for Adherence to Standards for Reporting of Diagnostic Accuracy Criteria

Abstract

Emergency point-of-care ultrasound (EUS) is widely used as a diagnostic tool in emergency departments (EDs) to guide clinical decisionmaking. Given its wide usage among emergency physicians as a diagnostic tool, rigorous study surrounding its accuracy as a diagnostic tool is essential. The Standards for Reporting of Diagnostic Accuracy (STARD) criteria were established in 2003 as a guide for investigators to ensure robust methodology for diagnostic studies. Adherence to the STARD criteria among EUS diagnostic studies has yet to be reported. Our objective was to evaluate an initial body of EUS literature for its adherence to the STARD criteria. Emergency point-of-care ultrasound studies published in 5 major emergency medicine journals from 2005-2010 were evaluated to establish for their initial adherence to the STARD criteria. Our initial literature search identified 307 studies pertaining to EUS. Of these, 45 met our inclusion criteria for review, meaning that they were studies evaluating core diagnostic EUS applications as outlined by the 2008 American College of Emergency Physicians. (ACEP 2008) Of the 45 articles in our review, only 29 (64%, 95% CI: 49% - 78%) evaluated the diagnostic accuracy of EUS with calculation and reporting of sensitivity and specificity. The remaining articles evaluated EUS as a diagnostic tool but did not report diagnostic accuracy information. The median STARD score across all articles was 15 (IQR: 12 - 17), which represents 60% of the total STARD criteria. The median STARD score among articles that reported diagnostic accuracy was significantly higher than those that reported EUS as a diagnostic tool but did not report accuracy [17 (IQR: 15 - 19) versus 11 (IQR: 9 - 13), respectively; p < 0.0001]. Seventy-one percent of articles met at least 50% of the STARD criteria (56%-84%) and 4% met greater than 80% of the STARD criteria. There is significant room to improve the adherence to the STARD criteria among EUS studies.