The value of highest quality ultrasound as a reference for ultrasound diagnosis

Aim: The aim of this study is to determine whether an additional ultrasound examination of DEGUM grade 3 (DEGUM 3) requested by examiners of DEGUM grade 1, 2 (DEGUM 1, 2) results in a diagnostic improvement. Methods: From October 2000 till June 2003 our university internal medicine sonography unit examined 34980 patients. In 211 cases DEGUM grade 1, 2 examiners requested a second opinion by DEGUM grade 3 examiners. 28 subjects were excluded because of unconfirmed diagnosis. Data of 183 patients with assured diagnoses were retrospectively analysed. We compared DEGUM 1, 2 findings with DEGUM 3 results regarding the accuracy of the firmed diagnosis. Results: In 38.8% (71 out of 183 subjects) the correct diagnosis was ascertained by DEGUM 1, 2. DEGUM 3 confirmed the correct diagnosis in 94.5% (173 out of 183 subjects). DEGUM 3 changed 106 (57.9%) findings of DEGUM 1, 2 and approved 77 findings (42.1%). In total DEGUM 3 diagnosed incorrectly twice compared to DEGUM 1, 2. In comparison to the assured diagnosis DEGUM 3 diagnosed 10 subjects incorrectly. Conclusion: The reference ultrasound examination done by an examiner with DEGUM grade 3 significantly increases the diagnostic accuracy compared to the ultrasonic measurement done by DEGUM grade 1, 2 investigators.