Evidence map›Paper›PMID 30430273›Full record

Trial reportHernia : the journal of hernias and abdominal wall surgery2019

Importance of the physical exam: double-blind randomized controlled trial of radiologic interpretation of ventral hernias after selective clinical information.

D V Cherla, K Bernardi, K J Blair, S S Chua, J P Hasapes, L S Kao, T C Ko, E J Matta, M L Moses, K G Shiralkar and 4 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Hernia : the journal of hernias and abdominal wall surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03121131 (How Important is a Clinical Data for a Radiologist? A Double-Blinded Randomized Controlled Trial of Radiologic Interpretation of Ventral Hernias Following Selectively-Provided Clinical Information), which is not on this map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03121131 nacompletednot on this map

How Important is a Clinical Data for a Radiologist? A Double-Blinded Randomized Controlled Trial of Radiologic Interpretation of Ventral Hernias Following Selectively-Provided Clinical Information

TypeinterventionalSponsorThe University of Texas Health Science Center, HoustonRan2017 to 2020Enrolled7ConditionsHerniaArmsClinical Exam Findings, Inaccurate Clinical Exam Findings, No clinical exam findings
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Botulinum toxin A in complex incisional hernia repair: a systematic review.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Pooled it
  2. Pooled it
  3. Trial
  4. Recommendations for the diagnosis of occult inguinal hernias using a modified Delphi technique.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 1 country.

D V CherlaDepartment of Surgery, Lyndon Baines Johnson Hospital, University of Texas Health Science Center at Houston, 5656 Kelley St, Suite 3OS62008, Houston, TX, 77026, USA.
K BernardiDepartment of Surgery, Lyndon Baines Johnson Hospital, University of Texas Health Science Center at Houston, 5656 Kelley St, Suite 3OS62008, Houston, TX, 77026, USA. karlabernardi.m@gmail.com.ORCID 0000-0001-5928-523X
K J BlairRadiology Department, University of Texas Health Science Center at Houston, Houston, TX, USA.
S S ChuaRadiology Department, University of Texas Health Science Center at Houston, Houston, TX, USA.
J P HasapesRadiology Department, University of Texas Health Science Center at Houston, Houston, TX, USA.
L S KaoDepartment of Surgery, Lyndon Baines Johnson Hospital, University of Texas Health Science Center at Houston, 5656 Kelley St, Suite 3OS62008, Houston, TX, 77026, USA.
T C KoDepartment of Surgery, Lyndon Baines Johnson Hospital, University of Texas Health Science Center at Houston, 5656 Kelley St, Suite 3OS62008, Houston, TX, 77026, USA.
E J MattaRadiology Department, University of Texas Health Science Center at Houston, Houston, TX, USA.
M L MosesDepartment of Surgery, Lyndon Baines Johnson Hospital, University of Texas Health Science Center at Houston, 5656 Kelley St, Suite 3OS62008, Houston, TX, 77026, USA.
K G ShiralkarRadiology Department, University of Texas Health Science Center at Houston, Houston, TX, USA.
V R SurabhiRadiology Department, University of Texas Health Science Center at Houston, Houston, TX, USA.
V S TammisettiRadiology Department, University of Texas Health Science Center at Houston, Houston, TX, USA.
C P VisoDepartment of Surgery, Lyndon Baines Johnson Hospital, University of Texas Health Science Center at Houston, 5656 Kelley St, Suite 3OS62008, Houston, TX, 77026, USA.
M K LiangDepartment of Surgery, Lyndon Baines Johnson Hospital, University of Texas Health Science Center at Houston, 5656 Kelley St, Suite 3OS62008, Houston, TX, 77026, USA.
Lyndon Baines Johnson Hospital · USThe University of Texas Health Science Center at Houston · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIncreasingly, radiologic imaging is obtained as part of the pathway in diagnosing ventral hernias. Often, radiologists receive incomplete or incorrect clinical information from clinicians.

objectiveThe aim of the study is to determine if clinical exam findings alter radiological interpretation of ventral hernias on CT.

methodsThis is a single-institution double-blind, randomized trial. All patients with a recent abdominal/pelvic CT scan seen in various surgical clinics were enrolled. A surgeon blinded to the CT scan findings performed a standardized physical examination and assessed for the presence of a ventral hernia. Seven independent radiologists blinded to the study design reviewed the scans. Each radiologist received one of three types of clinical exam data per CT: accurate (correct), inaccurate (purposely incorrect), or none. Allocation was random and stratified by the presence of clinical hernia. The primary outcome was the proportion of radiologic hernias detected, analyzed by chi square.

results115 patients were enrolled for a total of 805 CT scan reads. The proportion of hernias detected differed by up to 25% depending on if accurate, no, or inaccurate clinical information was provided. Inaccurate clinical data in patients with no hernia on physical exam led to a significant difference in the radiologic hernia detection rate (54.3% versus 35.7%, p = 0.007). No clinical data in patients with a hernia on physical exam led to a lower radiologic hernia detection rate (75.0% versus 93.8%, p = 0.001).

conclusionsThe presence and accuracy of clinical information provided to radiologists impacts the diagnosis of abdominal wall hernias in up to 25% of cases. Standardization of both clinical and radiologic examinations for hernias and their reporting are needed.

trial registrationClinicaltrials.gov, Number NCT03121131, https://clinicaltrials.gov/ct2/show/NCT03121131.

Indexed as

Hernia, VentralTomography, X-Ray ComputedDiagnostic ErrorsDouble-Blind MethodFemaleHumansMaleMiddle AgedPhysical ExaminationRadiography, AbdominalRadiologistsReproducibility of ResultsSurgeonsIncisional herniaProvider informationRadiologic accuracyRadiologic diagnosisUmbilical herniaVentral hernia

Identifiers

PMID30430273
OpenAlexW2901741900

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.