Accuracy of upper abdominal ultrasound examinations by sonographers in Norway

BackgroundNorway educated their first sonographers in 2008. The Norwegian Society of Radiology made a public statement discouraging Norwegian hospital departments of radiology to employ sonographers. Few sonographers work in Norway.PurposeTo investigate the accuracy of sonographers educated in Norway and to assess the quality of their work.Material and method244 patients were included in a prospective controlled study involving five sonographers and four advanced radiologists working in three separately located radiological departments belonging to the same hospital trust. All patients underwent ultrasound examinations by a sonographer and subsequently by an advanced radiologist who assessed the work of the sonographer.ResultsThe sonographers demonstrated a sensitivity of 0.97 and a specificity of 0.93, and there was an agreement of 0.9 (Cohens Kappa test) between the sonographers and the advanced radiologists. 95.1% of the sonographers' main findings were consistent with those of the radiologists. 99.2% of their examinations were found to be “best” or “medium” in the overall evaluation by the advanced radiologists. The advanced radiologists reported to have been mistaken in 3.3% of the cases where they considered the sonographers' results to be correct. If examined by the sonographers alone, pathology would have been undetected in 1.64% of the cases.ConclusionNorwegian sonographers are able to differentiate negative from positive findings in the upper abdomen, and demonstrate accuracies similar to experienced radiologists.