Read here: authors.elsevier.com/a/1l5Fs_siPe... or access via the QR code below 👇

What are the implications of this study ⁉️

3⃣ High-level #evidence from this study can inform future clinical #guidelines
4⃣ There is a need for prospective studies which address the challenges in achieving time-sensitive access ⏳ in pragmatic settings (e.g. #POCUS)

#UroSoMe

What are the implications of this study ⁉️

1⃣ Testicular torsion is an emergency - integration of #ultrasound into the pathway needs time-sensitive access ⏲️ AND clinical expertise 👩‍⚕️
2⃣ Ultrasound ➡️ excellent accuracy🌟 in expert hands but not 💯 - careful counselling essential

So why is this systematic review + meta-analysis different ⁉️

1⃣ #Cochrane methodology applied 🥇
2⃣ Collaborative team: urologists, radiologists, emergency physicians, expert stats/test accuracy experts👩‍🔬👨‍💻
3⃣ Significantly larger and more comprehensive than previous work 🎇

What else did we find ⁉️

1⃣ Patient age 👨‍🦱
2⃣ Use of Point-of-Care Ultrasound #POCUS
3⃣ Ultrasound user 👩‍⚕️

Did NOT lead to significant reduction in diagnostic accuracy 🌟

What were our study selection criteria ⁉️

1⃣ All patients receive an appropriate reference standard - scrotal exploration or follow-up
2⃣ Study must provide rates of true/false positives + negatives
3⃣ No restrictions on ultrasound technology, user, patient age, language, etc.

What are the problems we address here ⁉️

1⃣ Lack of high-quality evidence on accuracy ➡️ significant 🌎 variation in emergency use
2⃣ Hospitals with low emergency #ultrasound use ➡️ exploration -ve for torsion >75% ☹️
3⃣ Negative exploration ➡️ surgical morbidity + resource-intense

📊Take Home Message 📊
Colour Doppler Sonography 🔎 (42 studies, 4422 patients) showed 🌟excellent diagnostic accuracy 🌟for testicular torsion with:

➡️ SENSITIVITY = 95%
➡️ SPECIFICITY = 98%