Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale

被引：38

作者：

Laméris W. ^{[1
,2
]}

Van Randen A. ^{[1
,2
]}

Dijkgraaf M.G.W. ^{[3
]}

Bossuyt P.M.M. ^{[3
]}

Stoker J. ^{[2
]}

Boermeester M.A. ^{[1
]}

机构：

[1] Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam

[2] Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam

[3] Department of Clinical Epidemiology Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam

来源：

BMC Emergency Medicine | / 7卷 / 1期

关键词：

Emergency Department; Acute Abdomen; Acute Abdominal Pain; Case Record Form; Urgent Condition;

D O I：

10.1186/1471-227X-7-9

中图分类号：

学科分类号：

摘要：

Background: The acute abdomen is a frequent entity at the Emergency Department (ED), which usually needs rapid and accurate diagnostic work-up. Diagnostic work-up with imaging can consist of plain X-ray, ultrasonography (US), computed tomography (CT) and even diagnostic laparoscopy. However, no evidence-based guidelines exist in current literature. The actual diagnostic work-up of a patient with acute abdominal pain presenting to the ED varies greatly between hospitals and physicians. The OPTIMA study was designed to provide the evidence base for constructing an optimal diagnostic imaging guideline for patients with acute abdominal pain at the ED. Methods/design: Thousand consecutive patients with abdominal pain > 2 hours and < 5 days will be enrolled in this multicentre trial. After clinical history, physical and laboratory examination all patients will undergo a diagnostic imaging protocol, consisting of plain X-ray (upright chest and supine abdomen), US and CT. The reference standard will be a post hoc assignment of the final diagnosis by an expert panel. The focus of the analysis will be on the added value of the imaging modalities over history and clinical examination, relative to the incremental costs. Discussion: This study aims to provide the evidence base for the development of a diagnostic algorithm that can act as a guideline for ED physicians to evaluate patients with acute abdominal pain. © 2007 Laméris et al; licensee BioMed Central Ltd.

引用

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