Ultrasonography for the initial evaluation of blunt abdominal trauma: A review of prospective trials

Many trauma centers are considering the addition of diagnostic ultrasonography to their trauma protocols. However, a diagnostic imaging application should not be used in general clinical practice until its efficacy has been demonstrated. A literature search was conducted for prospective trials on the use of ultrasound in evaluation of blunt abdominal trauma. Each study was evaluated with the use of an efficacy assessment model. Within this framework, clinical outcomes were classified according to the following efficacy assessment parameters: technical capacity, diagnostic accuracy, diagnostic effect, therapeutic effect, and patient outcome. This model also provided a systematic process for grading the quality of research methods used to obtain each outcome. Eleven trials were found that fulfilled the study criteria, and all of them concluded that ultrasound was valuable for assessment of blunt intraperitoneal trauma. Frequent methodologic flaws were detected in these studies. None of these trials determined therapeutic effect or patient outcome. The criteria for clinical efficacy were not fulfilled. Additional trials should be conducted before ultrasound is accepted as a standard diagnostic test for the evaluation of blunt abdominal trauma.