Inter and intea-observer variation in ultrasonographic detection of gallstones: The Multicenter Italian Study on Epidemiology of Cholelithiasis (M.I.COL.)

Festi, Davide; Lalloni, L.; Taroni, Francesco; Leggett, Barbara A.; Menotti, Alessandro; Ricci, Giorgio

doi:10.1007/bf00145045

Cited by 17 publications

(15 citation statements)

References 21 publications

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“…In the second case presented here also, size erroneously would have been detected to be progressively getting bigger due to this inter-observer variation. This is also in line with the knowledge that there is a significant inter-observer variation in the nature of US (6,10,11). Follow-up by the same experienced radiologist would prevent unnecessary operations that could create many problems, in the long expected life of the child patients.…”

Section: In the Evaluation Of The Childhood Casessupporting

confidence: 75%

See 1 more Smart Citation

Decision for surgery in the management of a rare condition, childhood gallbladder polyps, and the role of ultrasonography

Kabaçam¹,

Akbiyik²,

Livanelioğlu³

et al. 2013

Turk J Gastroenterol

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Section: In the Evaluation Of The Childhood Casessupporting

confidence: 75%

“…magnetic resonance imaging and computed tomography) because it is easy to perform, with no radiation exposure, and less need for patient compliance. On the other hand, there is a well-known, significant risk of intra-observer as well as inter-observer variations (10,11). This can be particularly important in the pediatric age group.…”

mentioning

confidence: 99%

Decision for surgery in the management of a rare condition, childhood gallbladder polyps, and the role of ultrasonography

Kabaçam¹,

Akbiyik²,

Livanelioğlu³

et al. 2013

Turk J Gastroenterol

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“…The screening protocol included: upper abdomen ultrasonography (US), physical examination, fasting blood specimen collection, administration of a precoded questionnaire regarding family and personal history, dietary habits, past and current medical history, use of medications, detailed and documented information on a previous diagnosis of gallstones. A preliminary reliability study was performed for US examination 11 and questionnaire administration. 9 Evaluation of Abdominal Symptoms.…”

Section: Methodsmentioning

confidence: 99%

Clinical manifestations of gallstone disease: Evidence from the multicenter Italian study on cholelithiasis (MICOL)

et al. 1999

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Despite the many efforts to delineate the clinical manifestations of gallbladder disease, the precise symptom complex associated with gallstones is still a matter of debate, and even the existence of gallstone-specific symptoms has been questioned. We carried out a large population-based cross-sectional study (MICOL) to identify symptoms significantly related to gallstones. Fourteen centers throughout Italy enrolled 29,504 subjects aged 30 to 69 years. All subjects were administered an ultrasonographic examination of the upper abdomen and a precoded questionnaire. All subjects were divided into 4 groups: 25,374 (86.0%) gallstone-free subjects (GF), 1,832 (6.2%) patients with gallstones not previously diagnosed (GNPD), 638 (2.2%) patients with gallstones previously diagnosed (GPD), 1,660 (5.6%) patients with a history of cholecystectomy for gallstones (CC). In logistic regression analysis, pain at epigastrium and, even more, pain at right hypocondrium were significantly associated with gallstones. For pain at right hypocondrium, this association progressively increased from GNPD (OR ‫؍‬ 1.60, 95% CI ‫؍‬ 0.97-2.65) to GPD (OR ‫؍‬ 8.77, 95% CI ‫؍‬ 5.27-14.61) to CC (OR ‫؍‬ 59.40, 95% CI ‫؍‬ 43.87-80.42). Absence of heartburn combined with right hypocondrium or epigastrium pain and intolerance to fried or fatty food were also significantly related to gallstones. We also found some pain characteristics significantly associated with gallstones, i.e., pain radiated to the right shoulder, forcing the patient to rest, occurring soon after meals or unrelated to meals, not relieved by bowel movements, and frequently accompanied by gallstonerelated morbidities. We developed a probability tree reporting the cumulative probability of having gallstones for each combination of those symptoms and characteristics of pain significantly associated with gallstones. In conclusion, we have identified symptoms and signs significantly associated with gallstones. We have shown that there is an increase in frequency and severity of these symptoms and signs across the different stages of gallstone disease. We have proposed a complex of symptoms and signs significantly associated with gallstones that might help physicians in clinical decision making. (HEPATOLOGY 1999;30:839-846.)Despite the many efforts to delineate the clinical manifestations of gallbladder disease, the precise symptom complex associated with gallstones is still a matter of debate, and even the existence of gallstone-specific symptoms has been questioned. 1-3 Most of the attention has been focused on pain in gallstone patients, but there is no general agreement on its clinical meaning 3 and it is questioned whether pain occurs in gallstone disease with specific characteristics. 1,2 The identification of symptoms associated with this disease might help physicians in clinical decision making. [4][5][6][7] Moreover, the possibility of identifying patients who are more likely to have gallstones through a clinical assessment would limit the excessive and inappropriate use of di...

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“…The interand intraobserver variation in the US detection of GS was assessed by means of a reliability study, and standardized criteria for examination and diagnosis were applied by each operative unit. 38 Subjects reported in this article as having undiagnosed GS are those who showed presence of GS at US examination and answered negatively to the question: ''Have you ever had gallstones? ''…”

Section: Case Ascertainmentmentioning

confidence: 99%

Diet and gallstones in italy: The cross-sectional MICOL results†

Attili¹,

Scafato²,

Marchioli³

et al. 1998

Hepatology

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Fifteen thousand nine hundred ten men and 13,674 women (age, 30-69 years) were enrolled in an epidemiological survey of the general population, between December 1984 and April 1987. Each participant was submitted to ultrasonography (US) of the gallbladder and completed a food-frequency questionnaire, covering 38 food items. A common portion size was identified and subjects were asked how often each item was consumed. Nutrient intake was computed by multiplying the intake frequency and nutrient content per portion for each item, and then by summing the product over all foods. Each nutrient intake was adjusted for energy intake. Alcohol intake was calculated by summing the consumption of wine, beer, and liquor. Having excluded subjects aware of having gallstones (GS) or previously submitted to cholecystectomy (to avoid prothopatic bias), 787 males and 1,014 females with GS and 14,272 males and 10,836 females without GS were available for analysis. Relative risks (RR) of GS were computed by quintiles of nutrient intake. The overnight fasting period was calculated as the difference between the specified time of dinner and the time of the next meal (breakfast or lunch). A significant negative association was found between RR of GS and total energy intake for males ( 2 for trend ‫؍‬ 8.37; P ‫؍‬ .004), fiber intake for females ( 2 ‫؍‬ 5.45; P ‫؍‬ .02), and daily alcohol consumption for males ( 2 ‫؍‬ 10.86; P ‫؍‬ .001). A positive association was observed between RR of GS and carbohydrate ( 2 ‫؍‬ 5.95; P ‫؍‬ .01 for males; 2 ‫؍‬ 9.39; P ‫؍‬ .002 for females) and protein intake only for males ( 2 ‫؍‬ 10.92; P ‫؍‬ .01). Prevalence of GS was higher among subjects who had an overnight fasting period of over 12 hours than subjects with that of less than 12 hours. (RR: 1.35; 95% CI: 1.01-1.80 for males; RR: 1.28; 95% CI: 1.03-1.60 for females). These data do not confirm that high energy intake is associated with an increased risk of GS. Factors protecting against GS comprise: low carbohydrate (males and females) and protein (males) intakes, high fiber (females) and moderate alcohol intake (males) consumption, and a shorter overnight fasting period for both sexes. (HEPATOLOGY 1998;27:1492-1498.)Diet may influence the formation of gallstones (GS) either by modifying gallbladder motility or by altering the biliary lipid composition. The relationships between GS disease and the dietary habits in an Italian free-living population sample are analyzed and discussed in this article. The importance of diet in the pathogenesis of GS has been much debated. Information on this issue can be obtained from experimental, 1-18 clinical, 19-26 and epidemiological studies. [27][28][29][30][31][32][33][34][35] These latter studies have mainly investigated symptomatic GS subjects who were aware of having GS or subjects who had been previously submitted to cholecystectomy. Thus, it could be supposed that they accordingly modified their dietary habits. The present study only included subjects with asymptomatic, previously undiagnosed GS and compar...

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Inter and intea-observer variation in ultrasonographic detection of gallstones: The Multicenter Italian Study on Epidemiology of Cholelithiasis (M.I.COL.)

Cited by 17 publications

References 21 publications

Decision for surgery in the management of a rare condition, childhood gallbladder polyps, and the role of ultrasonography

Decision for surgery in the management of a rare condition, childhood gallbladder polyps, and the role of ultrasonography

Clinical manifestations of gallstone disease: Evidence from the multicenter Italian study on cholelithiasis (MICOL)

Diet and gallstones in italy: The cross-sectional MICOL results†

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