Evidence map›Paper›PMID 37410196›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2023

Diagnostic performance of CT with Valsalva maneuver for the diagnosis and characterization of inguinal hernias.

S Ghafoor, A Tognella, D Stocker, A M Hötker, M Kaniewska, T Sartoretti, A Euler, R Vonlanthen, M Bueter, H Alkadhi

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 6% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
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  3. Observational
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  5. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

S GhafoorDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. soleen.ghafoor@usz.ch.ORCID 0000-0002-8459-7363
A TognellaDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
D StockerDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-1230-092X
A M HötkerDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-4748-8758
M KaniewskaDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-7840-8415
T SartorettiDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-4812-987X
A EulerDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0001-5019-4585
R VonlanthenDepartment of Visceral and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland.ORCID 0000-0002-0212-6518
M BueterDepartment of Visceral and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland.ORCID 0000-0002-1391-0842
H AlkadhiDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-2581-2166
University of Zurich · CHUniversity Hospital of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeInguinal hernias are mainly diagnosed clinically, but imaging can aid in equivocal cases or for treatment planning. The purpose of this study was to evaluate the diagnostic performance of CT with Valsalva maneuver for the diagnosis and characterization of inguinal hernias.

methodsThis single-center retrospective study reviewed all consecutive Valsalva-CT studies between 2018 and 2019. A composite clinical reference standard including surgery was used. Three blinded, independent readers (readers 1-3) reviewed the CT images and scored the presence and type of inguinal hernia. A fourth reader measured hernia size. Interreader agreement was quantified with Krippendorff's α coefficients. Sensitivity, specificity, and accuracy of Valsalva-CT for the detection of inguinal hernias was computed for each reader.

resultsThe final study population included 351 patients (99 women) with median age 52.2 years (interquartile range (IQR), 47.2, 68.9). A total of 381 inguinal hernias were present in 221 patients. Sensitivity, specificity, and accuracy were 85.8%, 98.1%, and 91.5% for reader 1, 72.7%, 92.5%, and 81.8% for reader 2, and 68.2%, 96.3%, and 81.1% for reader 3. Hernia neck size was significantly larger in cases correctly detected by all three readers (19.0 mm, IQR 13, 25), compared to those missed by all readers (7.0 mm, IQR, 5, 9; p < 0.001). Interreader agreement was substantial (α = 0.723) for the diagnosis of hernia and moderate (α = 0.522) for the type of hernia.

conclusionValsalva-CT shows very high specificity and high accuracy for the diagnosis of inguinal hernia. Sensitivity is only moderate which is associated with missed smaller hernias.

Indexed as

Hernia, InguinalFemaleHerniorrhaphyHumansMiddle AgedRetrospective StudiesTomography, X-Ray ComputedValsalva ManeuverDiagnostic imagingHerniaInguinalMultidetector computed tomographyValsalva Maneuver

Identifiers

PMID37410196
PMCPMC10533612
OpenAlexW4383301991

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.