Abstract
Physical examinations that can be used to accurately diagnose intra-abdominal diseases important to high-value care because they reduce the number of unnecessary computed tomography (CT) studies for patients with acute abdominal pain. This prospective study was conducted to evaluate the diagnostic accuracy of the reversed Carnett’s (rCarnett’s) sign for intra-abdominal diseases detectable on abdominal CT. It was done in the outpatient department of the division of general internal medicine at a tertiary university hospital in Japan. Adult patients presenting with acute abdominal pain between August 2019 and January 2020 were included. The primary outcome was the diagnostic accuracy of rCarnett’s sign for intra- abdominal disease confirmed by abdominal CT. The diagnostic accuracy of each univariate and multivariate variable in logistic regression models was assessed by calculating the area under the receiver operating characteristic curve (AUROC). The data of 51 patients were included in this analysis. The rCarnett’s sign showed low diagnostic ability (AUROC:0.46, 95% confidence interval (CI):0.31 to 0.60, P = 0.54), sensitivity (32.4%, 95% CI:17.4% to 50.5%), and specificity (58.8%, 95% CI 32.9% to 81.6%). Thus, the rCarnett’s sign cannot be considered as an effective examination for the diagnosis of intra-abdominal diseases.
