Surgeon-performed ultrasound at the bedside for the detection of appendicitis and gallstones: Systematic review and meta-analysis

Background: We undertook a systematic review and meta-analysis to compare surgeon-performed ultrasound (SPUS) for suspected appendicitis or gallstone disease to the "gold standard" of pathological examination or radiologist-performed ultrasound (RPUS). Data Sources: MEDLINE, Embase, trial registries, conference proceedings, and article reference lists were searched to identify trials and/or studies comparing SPUS with pathology or RPUS as the reference standard. Data were abstracted from eligible studies to produce 2 × 2 contingency tables, permitting the calculation of pooled sensitivity and specificity values. Results: Eight studies (1,268 patients) evaluated SPUS for appendicitis. For appendicitis, SPUS had a pooled sensitivity of.92 (95% confidence interval [CI],.887-.939) and a pooled specificity of.96 (95% CI,.946-.974). SPUS for gallstones was evaluated in 8 studies (1,019 patients). The pooled sensitivity was.96 (95% CI,.934-.979), and the specificity was.99 (95% CI.983-.998). Conclusions: SPUS achieves acceptable sensitivity and specificity for both gallstones and appendicitis. However, there was some evidence of heterogeneity. Data regarding cost-effectiveness are lacking.