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Amin Z, Aw M, Soo R, Ooi S, Sivaraman P, Jin Fei Y, Chan E, Seng Gee L. Attitudes, Practice and Educational Preferences Towards Evidence-Based Medicine among Physicians in a Large Teaching Hospital. MEDICAL EDUCATION ONLINE 2007; 12:4464. [PMID: 28253101 DOI: 10.3402/meo.v12i.4464] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Evidence-based medicine (EBM) is an emerging must-know topic for today's physicians. The present literature is inadequate in identifying the attitudes, practice, and educational needs and preferred interventions of EBM. The objectives of this survey were to identify a) the attitude toward and practice of EBM among physicians, b) perceived benefits of EBM in daily practice, c) barriers to EBM practice, and d) preferred educational interventions. METHODS This was a questionnaire-based cross-sectional survey of physicians in a single large teaching hospital. RESULTS Overall, 56% of the physician respondents described the attitude towards EBM in their institution as positive. A similar number of physicians also reported the attitude of their colleagues towards EBM as favourable. 67% of the physicians believed EBM was useful in daily management of patients. In contrast, only 45% of the physicians actually practiced EBM in their daily patient management. The factors that discouraged them from actual practice include a lack of time, lack of exposure to EBM during their undergraduate curriculum, lack of endorsement, and fear of criticism by seniors. Physicians preferred less time consuming and less rigorous educational interventions such as clinical practice guidelines, journal club, and case review and discussion for teaching and learning EBM. INTERPRETATION There are disconnects between belief and actual practice and between preferred and ideal educational interventions of EBM among physicians surveyed.
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Wong ML, Fones CSL, Aw M, Tan CH, Low PS, Amin Z, Wong PS, Goh PS, Wai CT, Ong B, Tambyah P, Koh DR. Should non-expert clinician examiners be used in objective structured assessment of communication skills among final year medical undergraduates? MEDICAL TEACHER 2007; 29:927-932. [PMID: 18158667 DOI: 10.1080/01421590701601535] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Adoption of the objective structured clinical examination may be hindered by shortages of clinicians within a specialty. Clinicians from other specialties should be considered as alternative, non-expert examiners. AIMS We assessed the inter-rater agreement between expert and non-expert clinician examiners in an integrated objective structured clinical examination for final year medical undergraduates. METHODS Pairs of expert and non-expert clinician examiners used a rating checklist to assess students in 8 oral communication stations, representing commonly encountered scenarios from medicine, paediatrics, and surgery. These included breaking bad news, managing an angry relative, taking consent for lumbar puncture; and advising a mother on asthma and febrile fits, and an adult on medication use, lifestyle changes and post-suture care of a wound. 439 students participated in the OSCE (206 in 2005, 233 in 2006). RESULTS There was good to very good agreement (intraclass coefficient: 0.57-0.79) between expert and non-expert clinician examiners, with 5 out of 8 stations having intraclass coefficients > or =0.70. Variation between paired examiners within stations contributed the lowest variance to student scores. CONCLUSION These findings support the use of clinicians from other specialties, as 'non-expert' examiners, to assess communication skills, using a standardized checklist, thereby reducing the demand on clinicians' time.
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Amin Z, Khoo HE, Chong YS. Outcomes in Medical Education. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2007. [DOI: 10.47102/annals-acadmedsg.v36n9p711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Davis MH, Amin Z, Grande JP, O'Neill AE, Pawlina W, Viggiano TR, Zuberi R. Case studies in outcome-based education. MEDICAL TEACHER 2007; 29:717-722. [PMID: 18236260 DOI: 10.1080/01421590701691429] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Outcome-based education is one of the most significant global developments in medical education in recent years. This paper presents four case studies of outcome-based education from medical schools in different parts of the world; Scotland; USA; Pakistan; and Singapore. The outcome-based curricula have either been in place for some time, are evolving or are at the planning proposal stage. The outcomes, change process and implementation of the outcome-based approach are described. Variation in the extent to which each medical school has implemented outcome-based education is discussed and key points for successful implementation are highlighted. This paper is based on the pre-conference symposium "outcome-based curricula: global perspectives" presented by the authors at the 4th Asia Pacific Medical Education Conference (APMEC) in Singapore, 8-11 February, 2007.
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Amin Z, Khoo HE, Chong YS. Outcomes in medical education. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2007; 36:711-1. [PMID: 17925977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Amin Z, Theis B, Russell R, House C, Novelli M, Lees W. Diagnostic pancreatic cancer: the role of percutaneous biopsy and CT. Clin Imaging 2007. [DOI: 10.1016/j.clinimag.2007.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tan CH, Amin Z, Khoo HE, Gwee M, Davis M, Koh DR. Student perceptions of the benefits of problem-based learning. MEDICAL TEACHER 2007; 29:284. [PMID: 17701650 DOI: 10.1080/01421590601175333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Amin Z, Theis B, Russell RCG, House C, Novelli M, Lees WR. Diagnosing pancreatic cancer: the role of percutaneous biopsy and CT. Clin Radiol 2007; 61:996-1002. [PMID: 17097419 DOI: 10.1016/j.crad.2006.07.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Revised: 06/29/2006] [Accepted: 07/07/2006] [Indexed: 01/12/2023]
Abstract
AIMS To determine the sensitivity and complications of percutaneous biopsy of pancreatic masses, and whether typical computed tomography (CT) features of adenocarcinoma can reliably predict this diagnosis. MATERIALS AND METHODS A 5 year retrospective analysis of percutaneous core biopsies of pancreatic masses and their CT features was undertaken. Data were retrieved from surgical/pathology databases; medical records and CT reports and images. RESULTS Three hundred and three patients underwent 372 biopsies; 56 of 87 patients had repeat biopsies. Malignancy was diagnosed in 276 patients, with ductal adenocarcinoma in 259 (85%). Final sensitivity of percutaneous biopsy for diagnosing pancreatic neoplasms was 90%; for repeat biopsy it was 87%. Complications occurred in 17 (4.6%) patients, in three of whom the complications were major (1%): one abscess, one duodenal perforation, one large retroperitoneal bleed. CT features typical of ductal adenocarcinoma were: hypovascular pancreatic mass with bile and/or pancreatic duct dilatation. Atypical CT features were: isodense or hypervascular mass, calcification, non-dilated ducts, cystic change, and extensive lymphadenopathy. Defining typical CT features of adenocarcinoma as true-positives, CT had a sensitivity of 68%, specificity of 95%, positive predictive value (PPV) of 98%, and negative predictive value of 41% for diagnosing pancreatic adenocarcinoma. CONCLUSION Final sensitivity of percutaneous biopsy for establishing the diagnosis was 90%. CT features typical of pancreatic adenocarcinoma had high specificity and PPV. On some occasions, especially in frail patients with co-morbidity, it might be reasonable to assume a diagnosis of pancreatic cancer if CT features are typical, and biopsy only if CT shows atypical features.
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Khoo HE, Amin Z, Chong YS. Curriculum TIPS For All of Us. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2006. [DOI: 10.47102/annals-acadmedsg.v35n9p597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
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Khoo HE, Amin Z, Chong YS. Curriculum TIPS for all of us. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2006; 35:597-8. [PMID: 17051273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Amin Z, Hoon Eng K, Gwee M, Chay Hoon T, Dow Rhoon K. Addressing the needs and priorities of medical teachers through a collaborative intensive faculty development programme. MEDICAL TEACHER 2006; 28:85-8. [PMID: 16627332 DOI: 10.1080/01421590500314124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Faculty development in medical education is crucial for developing and sustaining quality education in medical schools. However, examples of successful intensive programmes based on experiential and collaborative learning are generally lacking in the literature. The Medical Education Unit of National University of Singapore conducted a three-day intensive programme on core competences in medical education. This paper highlights the process of programme development, programme structure, challenges faced and strategies adopted. It also describes the approach taken to educational programme evaluation along with the results. The programme structure was based on experiential and collaborative learning models. Participants contributed to all activities and emerged as facilitators and learners to gain first-hand experience of the complex educational processes. Each individual session was sequential with a brief plenary, demonstration, practicum and reflection. Pre-programme needs assessment showed that even the experienced teachers perceived a need to further improve their educational competencies.
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Vsiskin S, Amin Z. Emergency radiology. Rules and tools. By E Dick, I Francis, I Renfrew; and editor J Young, pp. 216, 2003 (Remedica Publishing Limited, London, UK) £25.00 ISBN 1901346 28 5. Br J Radiol 2005. [DOI: 10.1259/bjr.78.933.780872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Amin Z, Chong YS, Khoo HE. Towards better practices in medical student assessment. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2005; 34:471-2. [PMID: 16205822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Amin Z, Hoon Eng K, Gwee M, Dow Rhoon K, Chay Hoon T. Medical education in Southeast Asia: emerging issues, challenges and opportunities. MEDICAL EDUCATION 2005; 39:829-32. [PMID: 16048625 DOI: 10.1111/j.1365-2929.2005.02229.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
CONTEXT Medical education in Southeast Asian countries is undergoing rapid changes, with the realignment of medical schools' curricula to meet national needs and priorities, the adoption of and experimentation with innovations, and greater emphasis on staff development initiatives. The Medical Education Unit of the National University of Singapore undertook a project to compile the educational processes taking place in these medical schools. METHOD This was a process-focused initiative. We developed a custom-made questionnaire that emphasised narrative description. We compiled profiles of 30 selected medical schools in the Southeast Asian region and, after editing and review, published these profiles. This report summarises the key findings from the project. FINDINGS Medical schools in Southeast Asia are in a dynamic state. Schools are gradually adopting student-centred learning approaches, including problem-based learning. Many schools offer their students early clinical training, opportunities for out-of-hospital postings, and student-selected electives. Multiple-choice questions and oral examinations are almost universally used in student assessment. Portfolios and self- and peer-assessments are seldom used. Major challenges faced by the schools involve shortages of qualified staff and financial constraints. Major goals for the future include the implementation of student-centred learning, the revamping of the assessment process, and staff training. CONCLUSIONS This is a compilation of self-reported profiles of selected medical schools where we encouraged self-reflection and analysis. As with other surveys, there could be potential self-selection bias. Nevertheless, the profiles of these selected schools provide a broad overview of the status of medical schools in Southeast Asia.
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Amin Z. Radiology and imaging of the colon.Edited by A H Chapman. pp. xii+326, 2004 (Springer-Verlag, Berlin, Heidelberg, New York) £127.00 ISBN 3-540-43597-2. Br J Radiol 2005. [DOI: 10.1259/bjr.78.931.780674b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Amin Z, Tan Y, Pang C. A successful format for a breastfeeding advocacy skills workshop. MEDICAL EDUCATION 2005; 39:515. [PMID: 15842697 DOI: 10.1111/j.1365-2929.2005.02129.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Amin Z, Hoon Eng K, Chay Hoon T. A novel approach to faculty development programme evaluation. MEDICAL EDUCATION 2004; 38:1187-1188. [PMID: 15507020 DOI: 10.1111/j.1365-2929.2004.01991.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Cheng HK, Rajadurai VS, Amin Z, Sriram B, Yee MF, Han HH, Bock HL, Safary A. Immunogenicity and reactogenicity of two regimens of diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio and Haemophilus influenzae type b vaccines administered to infants primed at birth with hepatitis B vaccine. THE SOUTHEAST ASIAN JOURNAL OF TROPICAL MEDICINE AND PUBLIC HEALTH 2004; 35:685-92. [PMID: 15689088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
An open, randomized study evaluated the immune response and safety of two different regimens of diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated poliovirus-Haemophilus influenzae type b (DTPa-HBV-IPV-Hib) immunization in infants primed at birth with hepatitis B vaccine. One-half of the 150 healthy, full-term infants received a DTPa HBV-IPV-Hib vaccine at 1 1/2, 3 and 5 months of age; the other received a DTPa-IPV-Hib vaccine at 1 1/2, 3 and 5 months of age with separate HBV vaccine at 1 and 5 months of age. Immune response was similar following the two regimens with 100% of the vaccinees seroprotected for HBV, diphtheria, tetanus, Hib and poliovirus types 2 and 3 diseases after the full vaccination course. One vaccinee in the DTPa HBV-HPV- Hib group failed to respond to the poliovirus type 1 antigen. Response to the three pertussis antigens ranged from 92-97% in the DTPa-IPV-Hib plus separate HBV group and 100% in the DTPa HBV-IPV-Hib group. The most frequently reported post-vaccination symptoms were irritability in the DTPa-IPV-Hib plus separate HBV group (49% of vaccinees) and fever, defined as axillary temperature > or =37.5 degrees C, in the DTPa HBV- IPV-Hib group (50% of vaccinees).
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MESH Headings
- Antibodies, Bacterial/biosynthesis
- Antibodies, Bacterial/blood
- Antibodies, Viral/biosynthesis
- Antibodies, Viral/blood
- Diphtheria-Tetanus-Pertussis Vaccine/administration & dosage
- Diphtheria-Tetanus-Pertussis Vaccine/adverse effects
- Diphtheria-Tetanus-Pertussis Vaccine/immunology
- Drug Interactions
- Female
- Haemophilus Vaccines/administration & dosage
- Haemophilus Vaccines/adverse effects
- Haemophilus Vaccines/immunology
- Hepatitis B Vaccines/administration & dosage
- Hepatitis B Vaccines/adverse effects
- Hepatitis B Vaccines/immunology
- Humans
- Immunization Schedule
- Infant
- Infant, Newborn
- Male
- Poliovirus Vaccine, Inactivated/administration & dosage
- Poliovirus Vaccine, Inactivated/adverse effects
- Poliovirus Vaccine, Inactivated/immunology
- Safety
- Vaccines, Combined/adverse effects
- Vaccines, Combined/immunology
- Vaccines, Conjugate/adverse effects
- Vaccines, Conjugate/immunology
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Maheshwari S, Suresh PV, Bansal M, Mishra A, Sharma R, Amin Z. Perventricular device closure of muscular ventricular septal defects on the beating heart. Indian Heart J 2004; 56:333-5. [PMID: 15586743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
This report describes our initial experience with intraoperative device closure of muscular ventricular septal defects under echocardiographic guidance without cardiopulmonary bypass in two patients.
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Amin Z. Medical education in Asia: is it a time for optimism? ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2004; 33:264-6. [PMID: 15098646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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King LJ, Bell JRG, Healy JC, Amin Z, Predolac D, Wotherspoon A, Thompson J. Diagnosis and staging of pancreatic carcinoma: comparison of manganofodipir trisodium-enhanced magnetic resonance imaging and dynamic contrast-enhanced spiral computed tomography. Br J Surg 2003. [DOI: 10.1046/j.1365-2168.1999.1062h.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Background
The efficacy of manganofodipir trisodium (MnDPDP)-enhanced magnetic resonance imaging (MRI) and dual-phase dynamic contrast-enhanced spiral computed tomography (CT) in the diagnosis and staging of pancreatic carcinoma was compared.
Methods
Nineteen patients (eight men) aged 50–84 (mean 64) years with known or suspected pancreatic carcinoma were prospectively evaluated with MRI and CT. Precontrast T1 and T2 MRI sequences were supplemented by axial and coronal T1 images at 1·0 T, 20 min and 24 h following intravenous infusion of MnDPDP 0·5 ml/kg. Spiral CT was performed before contrast and dynamically after contrast during the pancreatic and portal venous phases of enhancement. The MRI and CT images were assessed independently by two observers blinded to the results of the other modality. The presence, site and size of any focal pancreatic mass were recorded and potential resectability was assessed by evaluating extraglandular extension, vascular involvement, lymphadenopathy, peritoneal spread and presence of hepatic metastases. Findings on MRI and CT were compared with the findings at surgery.
Results
Pancreatic adenocarcinomas were diagnosed histologically in 15 of 19 patients. MRI and CT each identified all of the proven malignancies. Clear evidence of irresectability with liver metastases or vascular invasion was identified in six of 15 patients at MRI, who did not therefore go on to surgery. In one of these six patients the CT findings were equivocal. Nine of the 15 patients went on to laparoscopy (n = 2) or laparotomy (n = 7). Of␣these nine patients seven were correctly assessed as resectable or␣irresectable on MRI and six by CT. The overall accuracy for assessing resectability was therefore 87 per cent for MRI and 73 per cent for CT. Liver metastases were confidently identified in three of 15 patients on both MRI and CT. Two patients with indeterminate liver lesions on CT were shown to have only benign liver lesions (cysts or haemangiomas) on MRI.
Conclusion
MnDPDP-enhanced MRI performed slightly better than dual-phase dynamic contrast-enhanced CT in the preoperative assessment of pancreatic tumour resectability. MRI also appears to offer an advantage in the evaluation of associated focal liver lesions.
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Miao YM, Koh DM, Amin Z, Healy JC, Chinn RJS, Zeegen R, Westaby D. Ultrasound and magnetic resonance imaging assessmentof active bowel segments in Crohn's disease. Clin Radiol 2002; 57:913-8. [PMID: 12413916 DOI: 10.1053/crad.2002.1059] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM Determining bowel disease activity in Crohn's patients can be difficult on clinical and laboratory assessment. Endoscopy is invasive and barium studies use ionising radiation. The aim of this study was to compare ultrasound and magnetic resonance imaging (MRI) in detecting Crohn's disease activity in the small or large bowel. MATERIALS AND METHODS Thirty patients, previously diagnosed with Crohn's disease, had bowel ultrasound and MR imaging, and were deemed active or inactive on each test. The 'gold standard' was based on clinical assessment and one or more of the following: endoscopy, barium studies or surgery. RESULTS For determining Crohn's disease activity, the sensitivities and specificities of bowel ultrasound and MRI were 87 percent and 100 percent, and 87 percent and 71 percent, respectively. Significant parameters that defined disease activity were bowel wall thickening on ultrasound and MRI, and contrast enhancement of the bowel wall and mesenteric vascularity/stranding on MRI. CONCLUSION Ultrasound and MRI were both sensitive for determining Crohn's disease activity in the bowel, but MRI with gadolinium enhancement was less specific.
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Koh DM, Miao Y, Chinn RJ, Amin Z, Zeegen R, Westaby D, Healy JC. MR imaging evaluation of the activity of Crohn's disease. AJR Am J Roentgenol 2001; 177:1325-32. [PMID: 11717076 DOI: 10.2214/ajr.177.6.1771325] [Citation(s) in RCA: 299] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the sensitivity and specificity of MR imaging in assessing the activity of Crohn's disease. SUBJECTS AND METHODS Thirty symptomatic patients with Crohn's disease but uncertain disease activity were prospectively examined using MR imaging. Twenty-nine patients were scored using the Crohn's disease activity index. Six hundred milliliters of water orally and 1 mg of glucagon intramuscularly were given before imaging. Breath-hold images were obtained using T2-weighted turbo spin-echo, T1-weighted fast low-angle shot, and fat-suppressed gadolinium-enhanced T1-weighted fast low-angle shot sequences. Images were assessed by two radiologists who were unaware of the patient's symptoms, clinical scoring, and other imaging tests, and who reached a consensus about the imaging findings (bowel wall thickening, bowel wall enhancement, and perienteric changes) and determined the absence or presence of active disease in each patient. MR imaging findings were correlated with endoscopy and surgery. RESULTS Twenty-three patients had active disease and seven patients had inactive disease. One hundred twenty-four of a total of 168 bowel segments were examined with both MR imaging and endoscopy or surgery. On a per patient basis, MR imaging had an overall sensitivity of 91% and a specificity of 71% for active disease. The Crohn's disease activity index had a sensitivity of 92% and a specificity of 28%. On a per segment basis, MR imaging had a sensitivity of 59% and a specificity of 93%. Bowel wall thickening of greater than 4 mm, bowel wall enhancement (ratio of signal intensity of abnormal to normal bowel > 1.3:1), and increased mesenteric vascularity were useful in identifying active disease. A layered enhancement pattern after the IV administration of gadolinium was highly specific for active inflammation. CONCLUSION MR imaging is useful in assessing the activity of Crohn's disease and may be helpful when clinical scoring is equivocal.
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