PENILAIAN JURNAL PENELITIAN DIAGNOSTIK BERDASARKAN CEKLIST STARD (Standards for the Reporting of

Diagnostic Accuracy Studies)

Keterangan:
Warna merah di dalam penilaian ini menunjukkan bukti adanya rekomendasi ceklist STARD di dalam jurnal.
A. Penilaian Jurnal Berdasarkan Ceklist STARD
Letak
Nomor Ceklist di
Bagian Jurnal Rekomendasi dari Ceklist STARD Keterangan dan Bukti pada Jurnal
Bagian Halaman
Jurnal
862 - Pada judul
Identification as a study of
Accuracy of clinician-performed point-of-
diagnostic accuracy using at least
care ultrasound for the diagnosis of fractures
one measure of accuracy (such as
Tittle/Abstract 1 in children and young adults
sensitivity, specificity, predictive
- Pada kata kunci
values, or AUC).
Sensitivity and specificity
- Pada abstrak
 Our objective was to determine the accuracy
of clinician-performed point-of-care
ultrasound for the diagnosis of fractures in
children and young adults presenting to an
acute care setting.
862 - Desain penelitian
We conducted a prospective cohort study of
patients aged <25 years that presented to
emergency departments with injuries
requiring X-rays or CT for suspected fracture.
Structured summary of study
- Metode
design, methods, results, and
We conducted a prospective cohort study of
Abstract 2 conclusions (for specific guidance,
patients aged <25 years that presented to
see STARD for Abstracts).
emergency departments with injuries
requiring X-rays or CT for suspected fracture.
X- rays or CT were used as the reference
standard to determine test performance
characteristics.
- Hasil
 Point-of-care ultrasound was performed on
212 children and young adults with 348
suspected fractures. Forty-two percent of all
bones imaged were non-long bones. The
prevalence rate of fracture was 24%.
- Kesimpulan
Clinicians with focused ultrasound training
were able to diagnose fractures using point-
of-care ultrasound with a high specificity rate.
Specificity rates to rule-in fracture were
similar for non-long bone and long bone
fractures, as well as in skeletally mature
young adults and children with open growth
plates. Clinician-performed point-of-care
ultrasound accuracy was highest at the
diaphyses of long bones, while most
diagnostic errors were committed at the ends-
of-bones or near joints. Point-of-care
ultrasound may serve as a rapid alternative
 means to diagnose midshaft fractures in
settings with limited or no access to X-ray.
862-863 - Latar belakang klinis
Diagnostic testing with X-ray is routinely
performed to evaluate for fractures, which are
diagnosed in approximately 20% of
emergency department visits for childhood
injuries.36 However, the World Health
Organisation estimates that up to three-
Scientific and clinical background,
quarters of the world population has no
including the intended use and
Introduction 3 access to any diagnostic imaging services.44
clinical role of the index test.
Thus injuries resulting in fractures may be
inadequately evaluated and treated,
especially in resource-poor settings around
the world where disparities in diagnostic
imaging services exist.
- Clinical role of the index test
Clinician-performed point-of-care ultrasound
is an imaging modality that has emerged as a
 rapid and versatile diagnostic tool in acute
and critical care settings,4,17 for both
paediatric and adult patients.7,14 Similarly,
point-of-care ultrasound use by clinicians of
many different medical specialties, beyond
traditional users such as cardiologists and
obstetrician-gynecologists, has grown expo-
nentially in the past decade.1,7,14,15,17,18,19
Because of the greater availability of
inexpensive and compact ultrasound
machines, clinician-performed point-of-care
ultrasonography is feasible, not only in
traditional acute care settings, but also in
healthcare settings that lack or have limited
diagnostic imaging capability. These settings
include developing countries, disaster or
military conflict zones, and austere or remote
locations.16,20,30,34
- Intended use and rationality
In U.S. military combat operations in Iraq and
Afghanistan, point-of-care ultrasound
diagnosis offractures and other injuries has
been useful in assisting battlefield triage and
evacuation decisions.20 In published
guidelines for essential trauma care, the
World Health Organisation has also
recommended ultrasound as desirable
equipment available at all hospital-level
healthcare facilities around the world.24 The
reflective acoustic properties of cortical bone
make ultrasound imaging highly specific for
identifying fractures as small as 1 mm.10
Researchers in trauma ultrasonography have
advocated to include evaluation ofinjured
extremities for fractures as part of the
extended Focused Assessment with
Sonography in Trauma (eFAST)
examination.9,19 This research has focused on
 the use of point-of-care ultrasound in
musculoskeletal injuries and fracture
diagnosis in adults,9,19,37 with data in children
limited primarily to long bone fractures and
guided reduction.8,12,27,41,42
863 - Tujuan penelitian
Our objective was to determine the test
performance characteristics of clinician-
performed point-of-care ultrasound,
compared to X-ray or CT scan, for the
diagnosis of long bone and non-long bone
fractures in children and young adults
4 Study objectives and hypotheses.
presenting to an acute care setting.
- Hipotesis
Clinician-performed point-of-care ultrasound
diagnosis for suspected fractures in injured
children and military age young adults has
potential utility that warrants further
investigation.
Methods

863 This prospective observational study was

conducted from July 1, 2007 to May 31, 2008 at
Whether data collection was two affiliated urban emergency departments. The
planned before the index test and study was approved by our institutional review
reference standard were performed board. The study population consisted of a
a. Study design 5
(prospective study) or after convenience sample of patients who met pre-
(retrospective study). determined inclusion criteria and in whom
informed consent had been obtained and
documented from patient or guardian for
enrollment into the study (Fig. 1).
863 Inclusion criteria consisted of the following: (1)
patients <25 years of age (sub grouped into
children <18 years old with open growth plates,
b. Participants 6 and skeletally mature 18–24 year olds eligible for
military service) presenting to the emergency
Eligibility criteria. department with a musculoskeletal injury
requiring X-ray(s) or computed tomography; (2)

On what basis potentially eligible
7
participants were identified (such
the injured body part contained a bone with an
identifiable linear cortex on point-of-care
ultrasound; eligible long bones included the
humerus, radius, ulna, femur, tibia, and fibula;
eligible non-long bones included skull, mandible,
clavicle, rib, metacarpal, phalanx, patella, and
metatarsal. Exclusion criteria consisted of: (1)
gross deformity of the injured body part (to
maintain diagnostic uncertainty); (2) arrival in the
emergency department with prior diagnosis of
fracture or X-ray of fracture; (3) haemodynamic
instability; (4) need for emergent surgery; (5)
laceration over the injury or suspected open
fracture. Patients were informed that they could
withdraw from the study at any point. We collected
information regarding pain during ultrasound
examination.
863 Bones were identified as positive or negative for
fracture based on the presence or absence of
 as symptoms, results from previous cortical interruption or irregularity on point-of-
tests, inclusion in registry). care ultrasound (Fig. 2).
The reference gold standard for fracture was the
attending radiologist reading of the X-ray, or
computed tomography for skull and mandible
fractures (standard of care at our institution).
Where and when potentially eligible 863 This prospective observational study was
participants were identified conducted from July 1, 2007 to May 31, 2008 at
8
(setting, location and dates). two affiliated urban emergency departments.

863 The study population consisted of a convenience

Whether participants formed a
sample of patients who met pre-determined
consecutive, random or
9 inclusion criteria and in whom informed consent
convenience series.
had been obtained and documented from patient
or guardian for enrollment into the study (Fig. 1).
863-864 - Praanalitik
Index test, in sufficient detail to
c. Test Method Inclusion criteria consisted of the following:
10a allow replication.
(1) patients <25 years of age (sub grouped
into children <18 years old with open growth
plates, and skeletally mature 18–24 year olds
eligible for military service) presenting to the
emergency department with a musculoskeletal
injury requiring X-ray(s) or computed
tomography; (2) the injured body part
contained a bone with an identifiable linear
cortex on point-of-care ultrasound; eligible
long bones included the humerus, radius,
ulna, femur, tibia, and fibula; eligible non-
long bones included skull, mandible, clavicle,
rib, metacarpal, phalanx, patella, and
metatarsal. Exclusion criteria consisted of:
(1) gross deformity of the injured body part
(to maintain diagnostic uncertainty); (2)
arrival in the emergency department with
prior diagnosis of fracture or X-ray of
fracture; (3) haemodynamic instability; (4)
need for emergent surgery; (5) laceration
over the injury or suspected open fracture.
 Patients were informed that they could
withdraw from the study at any point. We
collected information regarding pain during
ultrasound examination.
Study sonologists (physicians who perform
and interpret ultrasound) consisted of 10
paediatric emergency physicians with varying
levels of emergency ultrasound experience.4
They under- went 1 h of point-of-care
musculoskeletal ultrasound training session
prior to enrolling patients. The training
consisted of a 30-min lecture viewing
ultrasound video of various fractures,
followed by a 30-min practical hands-on
scanning session of normal bone anatomy and
simulated fractures. Sonologists recorded
demographic data prior to the point-of-care
ultrasound examination.
- Analitik
Ultrasound machines with a linear array
transducer at 7.5–10 MHz (Sonosite
Micromaxx, Bothell, WA, and Siemens GS60,
Mountain View, CA) were used to image
bones in perpendicular orthogonal planes
(long and short axes) starting at the area of
maximal pain. Ultrasound gel was layered
onto this area with the ultrasound probe
applied to the layer of gel to avoid physical
contact or pressure on the injured body part.
For younger children, imaging the
contralateral normal body part was
encouraged as necessary, in order to gain the
child’s acceptance of the ultrasound
examination. Fracture was defined as cortical
disruption or irregularity (Fig. 2) when
scanning along the long axis of the bone.
Fractures were also visualised when
dynamically scanning along the short axis39
(transverse plane), by identifying the skipping
or discontinuity effect depending on the
degree of fracture displacement (long bones
in particular). Additional oblique or
longitudinal views of the injured area were
obtained as necessary. Sonologists were
encouraged to image the unaffected
contralateral body part for comparison when
uncertainty arose. Additionally, sonologists
were also encouraged to optimise image
quality using a water bath technique to image
hands and feet.5
The analysis of diagnostic errors is often not
reported in studies of diagnostic tests,26 and
research in ultrasound has not been an
exception. To examine diagnostic errors,
quality assurance monitoring was performed
by a senior sonologist with 10 years of point-
of-care ultrasound experience who reviewed
 all enrolled point-of-care ultrasound scans
via digital movie clips and still images to
classify diagnostic errors made by study
sonologists.
- Pasca analitik
Demographic data are reported as
frequencies, medians with inter-quartile
range for ordered non-normal data, and
means with standard deviations for
continuous normal data. Discrete and ordinal
variables are described as counts and
proportions. We calculated point-of-care
ultrasound test performance character- istics,
including sensitivity, specificity, positive and
negative likelihood ratios, with 95%
confidence intervals.
Reference standard, in sufficient 863-864 - Praanalitik
10b detail to allow replication. Inclusion criteria consisted of the following:
(1) patients <25 years of age (sub grouped
into children <18 years old with open growth
plates, and skeletally mature 18–24 year olds
eligible for military service) presenting to the
emergency department with a musculoskeletal
injury requiring X-ray(s) or computed
tomography; (2) the injured body part
contained a bone with an identifiable linear
cortex on point-of-care ultrasound; eligible
long bones included the humerus, radius,
ulna, femur, tibia, and fibula; eligible non-
long bones included skull, mandible, clavicle,
rib, metacarpal, phalanx, patella, and
metatarsal. Exclusion criteria consisted of:
(1) gross deformity of the injured body part
(to maintain diagnostic uncertainty); (2)
arrival in the emergency department with
prior diagnosis of fracture or X-ray of
fracture; (3) haemodynamic instability; (4)
need for emergent surgery; (5) laceration
 over the injury or suspected open fracture.
Patients were informed that they could
withdraw from the study at any point. We
collected information regarding pain during
ultrasound examination.
- Analitik
The reference gold standard for fracture was
the attending radiologist reading of the X-ray,
or computed tomography for skull and
mandible fractures (standard of care at our
institution).
- Pasca analitik
Demographic data are reported as
frequencies, medians with inter-quartile
range for ordered non-normal data, and
means with standard deviations for
continuous normal data. Discrete and ordinal
variables are described as counts and
proportions. We calculated point-of-care
 ultrasound test performance characteristics,
including sensitivity, specificity, positive and
negative likelihood ratios, with 95%
confidence intervals.
863 - Rasionalisasi pemilihan
The reference gold standard for fracture was
the attending radiologist reading of the X-ray,
or computed tomography for skull and
mandible fractures (standard of care at our
institution).
Rationale for choosing the
- Pengaruh hasil reference standard terhadap
reference standard (if alternatives
11 pembacaan index test
exist).
Bones of the wrist and proximal foot were
excluded from our ultrasound imaging
protocol (unable to visualise intra-articular
cortices on ultrasound). Fractures in these
areas identified by the reference standard
were counted as missed fractures when
calculating test performance characteristics.
 864 Fracture was defined as cortical disruption or
Definition of and rationale for test
irregularity (Fig. 2) when scanning along the long
positivity cut-offs or result
axis of the bone. Fractures were also visualised
categories of the index test,
12a when dynamically scanning along the short axis39
distinguishing pre-specified from
(transverse plane), by identifying the skipping or
exploratory.
discontinuity effect depending on the degree of
fracture displacement (long bones in particular).
863 Bones of the wrist and proximal foot were
Definition of and rationale for test excluded from our ultrasound imaging protocol
positivity cut-offs or result (unable to visualise intra-articular cortices on
categories of the reference ultrasound). Fractures in these areas identified by
12b
standard, distinguishing pre- the reference standard were counted as missed
specified from exploratory. fractures when calculating test performance
characteristics.
Diagram pada gambar 1
 863
Whether clinical information and
reference standard results were
13a available to the performers/readers
of the index test.
863
Whether clinical information and
13b
index test results were available to
Results of the point- of-care ultrasound were
compared to the reference gold standard to
determine test performance characteristics.
Sonologists were blinded to X-ray or computed
tomography results when perform- ing the point-
of-care ultrasound. Radiologists were blinded to
the point-of-care ultrasound examination results.
Results of the point-of-care ultrasound were
compared to the reference gold standard to
determine test performance characteristics.
 the assessors of the reference Sonologists were blinded to X-ray or computed
standard. tomography results when perform- ing the point-
of-care ultrasound. Radiologists were blinded to
the point-of-care ultrasound examination results.
864 We calculated point-of-care ultrasound test
performance characteristics, including sensitivity,
Methods for estimating or specificity, positive and negative likelihood ratios,
comparing measures of diagnostic with 95% confidence intervals. Data analysis and
14
accuracy. test performance characteristics were calculated
using SPSS Version 11.0 for Windows (SPSS
Chicago, IL), and Microsoft Office Excel 2003
d. Analysis
(Microsoft, Inc., Redmond, Washington). In
863-864 Bones of the wrist and proximal foot were
excluded from our ultrasound imaging protocol
How indeterminate index test or
(unable to visualise intra-articular cortices on
reference standard results were
15 ultrasound). Fractures in these areas identified by
handled.
the reference standard were counted as missed
fractures when calculating test performance
characteristics. Additionally, missed fractures
involving paired adjacent bones that were not
examined by ultrasound (e.g. imaged tibia, but
fracture of fibula, imaged radius but fracture of
ulna, etc.) were also included in the analysis of test
performance characteristics. These measures
were taken to avoid the possibility of inflated test
performance characteristics of point-of-care
ultrasound relative to X-ray and computed
tomography.
The analysis of diagnostic errors is often not
reported in studies of diagnostic tests,26 and
research in ultrasound has not been an exception.
To examine diagnostic errors, quality assurance
monitoring was performed by a senior sonologist
with 10 years of point-of-care ultrasound
experience who reviewed all enrolled point-of-
care ultrasound scans via digital movie clips and
still images to classify diagnostic errors made by
study sonologists.
 863 Bones of the wrist and proximal foot were
excluded from our ultrasound imaging protocol
(unable to visualise intra-articular cortices on
ultrasound). Fractures in these areas identified by
How missing data on the index test the reference standard were counted as missed
and reference standard were fractures when calculating test performance
16
handled. characteristics. Additionally, missed fractures
involving paired adjacent bones that were not
examined by ultrasound (e.g. imaged tibia, but
fracture of fibula, imaged radius but fracture of
ulna, etc.) were also included in the analysis of test
performance characteristics.
864 In addition to calculating overall test
Any analyses of variability in characteristics with 95% confidence intervals, we
diagnostic accuracy, distinguishing analysed the test characteristics ofseveral
17
pre-specified from exploratory. subgroups, including: age <18 years vs. age 18–
24 years, long bones vs. non- long bones, and
sonologists with >25 musculoskeletal ultrasound
 examinations performed vs. novice sonologists
with ≤25 examinations.
864 Demographic data are reported as frequencies,
medians with inter-quartile range for ordered
non-normal data, and means with standard
deviations for continuous normal data. Discrete
and ordinal variables are described as counts and
proportions. We calculated point-of-care
ultrasound test performance character- istics,
Intended sample size and how it was including sensitivity, specificity, positive and
18 determined. negative likelihood ratios, with 95% confidence
intervals. Data analysis and test performance
characteristics were calculated using SPSS
Version 11.0 for Windows (SPSS Chicago, IL),
and Microsoft Office Excel 2003 (Microsoft, Inc.,
Redmond, Washington). In addition to calculating
overall test characteristics with 95% confidence
intervals, we analysed the test characteristics of
several subgroups, including: age <18 years vs.
 age 18–24 years, long bones vs. non- long bones,
and sonologists with >25 musculoskeletal
ultrasound examinations performed vs. novice
sonologists with ≤25 examinations.

Results

863

Flow of participants, using a

a. Participants
19 diagram.
 864

Baseline demographic and clinical

20 characteristics of participants.

866 - Bukti distribusi derajat fraktur dibandingkan

Distribution of severity of disease in
21a those with the target condition.
dengan kondisi normal (halaman 866).
Cortical irregularity or disruption when
compared to the normal contralateral side
was still the main finding despite the presence
of the growth plate (for Salter Harris 1
through 4 injuries).

- Sebagai keterangan pendukung, berikut

merupakan spektrum hasil imaging USG
terhadap setiap daerah fraktur (tabel 3
halaman 865).
 Distribution of alternative - -
diagnoses in those without the
21b
target condition.

Time interval and any clinical - -

interventions between index test and
22
reference standard.

Cross tabulation of the index test
results (or their distribution) by the
b. Test Result
23 results of the reference standard.
- Dalam hal ini, hanya disampaikan distribusi
sensitivitas, spesifisitas, nilai duga positif, dan
nilai duga negatif dari hasil kalkulasi tabulasi
silang pada tabel 2 dan 3 karena banyaknya data
yang dianalisis.
 865 Point-of-care ultrasound test performance
Estimates of diagnostic accuracy
characteristics for diagnosing fractures with 95%
24 and their precision (such as 95%
confidence intervals for the overall study and
confidence intervals).
subgroups of interest are presented in Table 2.
 Test performance characteristics of point-of-care
ultrasound for individual bones with 95%
confidence intervals are presented in Table 3.
Any adverse events from performing - Tidak ada pasien yang mengeluhkan nyeri ataupun
the index test or the reference tidak mampu menyelesaikan pemeriksaan
25
standard. (dijelaskan di halaman 864-865)

867 Due to the limited sample size for individual bones

and subgroups, we suggest caution in interpreting
the results in Tables 2 and 3, when comparing
point-of-care ultrasound sensitivity and specificity
Study limitations, including sources for individual bones and subgroups. Further
Discussion of potential bias, statistical investigations with larger sample sizes are needed
26
uncertainty, and generalisability. to confirm test performance characteristics of
individual bones. The majority (86%) of errors in
our study occurred at the ends-of-bones or near
joints that are more difficult to evaluate because
of curved, sometimes irregular contours. These
errors still occurred despite encouraging our

Implications for practice, including
the intended use and clinical role of
27
the index test.
study sonologists to scan the contralateral
unaffected side.
Our study was also limited in that we excluded
wrist bones and proximal foot bones due to the
difficulty in evaluating intra- articular cortical
surfaces and contours of these particular bones by
ultrasonography. We were unable to evaluate the
accuracy of point-of-care ultrasound for nasal
bone fractures in our study as it is not our routine
practice to obtain X-ray for suspected isolated
nasal bone fractures. However, the evaluation of
nasal bones, as well as facial bones and scaphoid
bones by ultrasonography has been described in
the literature.
866 Based on the lower sensitivity of point-of-care
ultrasound in our study, particularly our lower
accuracy at the end-of-bones or near joints, it is
unlikely that ultrasound will replace X-ray for
fracture diagnosis in settings with access to X-
rays. However, our data and that of other studies
suggest that point-of-care ultrasound may be an
alternative to X- ray in identifying fractures of the

diaphyses (shafts) of long bones,8,12,27,41

skull,35 ribs,45 and distal humerus (via

visualisation of the posterior fat pad21,33,40,46),

especially in sonologists with >25 training exams.
Identifying skull fractures in children may be of
particular interest, given the 100% accuracy in
our limited sample, and the desire to avoid higher
doses of radiation to the paediatric brain from
computed tomography. Point-of-care ultra- sound
has also been shown to accurately guide fracture

reduc- tion,8,27,42 and may avoid multiple doses

of radiation from fluoroscopy or repeat X-rays.
In settings where X-ray is not available,
ultrasound can serve as a valuable, easy to learn,
and portable tool for fracture diagnosis. These
settings include mass casualty events, military
combat zones, wilderness/rural medicine, and

prehospital care.13,16,20,29,30,34 In the

developing world, ultrasound can have an even
greater impact due to its low cost and the
widespread lack of diagnostic imaging

services.22,34 Real-time and remote supervision

of novice sonologists by transmission of digital
images has been demonstrated in austere

environments or resource scarce locations13,29

and may allow for improved accuracy.
 862 - Name of registry
© 2010 Elsevier Ltd. All rights reserved.
Registration number and name of
- Registration number
28 registry.
0020–1383/$ – see front matter © 2010 Elsevier
Ltd. All rights reserved.
Other Information doi:10.1016/j.injury.2010.04.020
Where the full study protocol can be - Tidak tersedia dalam jurnal ini.
29 accessed.

Sources of funding and other 867 This study was conducted without funding. We
30 support; role of funders. have no financial conflicts of interests to disclose.

Tabel 1. Ceklist STARD (Bossuyt et al., 2015).

B. Ceklist STARD Khusus Abstrak Jurnal

 Bagian Abstrak
Rekomendasi dari Ceklist STARD Keterangan dan Bukti pada Jurnal
(halaman 862)
Our objective was to determine the accuracy of
Background and clinician-performed point-of-care ultrasound for the
Study objectives.
Objectives diagnosis of fractures in children and young adults
presenting to an acute care setting.
We conducted a prospective cohort study of patients
Data collection: whether this was a prospective aged <25 years that presented to emergency
or retrospective study. departments with injuries requiring X-rays or CT for
suspected fracture.
We conducted a prospective cohort study of patients
Methods Eligibility criteria for participants and settings aged <25 years that presented to emergency
where the data were collected. departments with injuries requiring X-rays or CT for
suspected fracture.
Menggunakan convenience sampling.
Whether participants formed a consecutive,
We conducted a prospective cohort study of patients
random or convenience series.
aged <25 years that presented to emergency
 departments with injuries requiring X-rays or CT for
suspected fracture.

Metode sampling dipertegas di bagian metode jurnal.

The study population consisted of a convenience sample
of patients who met pre-determined inclusion criteria
and in whom informed consent had been obtained and
documented from patient or guardian for enrollment into
the study (Fig. 1).
Paediatric emergency physicians with a 1 h training
Description of the index test and reference session diagnosed fractures by point-of-care ultrasound.
standard. X- rays or CT were used as the reference standard to
determine test performance characteristics.
Point-of-care ultrasound was performed on 212 children
Number of participants with and without the and young adults with 348 suspected fractures. Forty-
target condition included in the analysis. two percent of all bones imaged were non-long bones.
Results
The prevalence rate of fracture was 24%.
Estimates of diagnostic accuracy and their Overall: sensitivity—73% (95% CI: 62–82%),
precision (such as 95% confidence intervals). specificity—92% (95% CI: 88–95%); long bones:
 sensitivity—73% (58–84%), specificity—92% (86–
95%); non-long bones: sensitivity—77% (58–90%);
specificity—93% (87–97%); age ≥ 18 years:
sensitivity—60% (39–78%), specificity—92% (87–
96%); age < 18: sensitivity—78 (65–87%), specificity—
93% (87–95)%.
Clinicians with focused ultrasound training were able to
diagnose fractures using point-of-care ultrasound with a
high specificity rate. Specificity rates to rule-in fracture
were similar for non-long bone and long bone fractures,
General interpretation of the results. as well as in skeletally mature young adults and children
with open growth plates. Clinician-performed point-of-
Discussion
care ultrasound accuracy was highest at the diaphyses
of long bones, while most diagnostic errors were
committed at the ends-of-bones or near joints.
Point-of-care ultrasound may serve as a rapid
Implications for practice, including the
alternative means to diagnose mid shaft fractures in
intended use of the index test.
settings with limited or no access to X-ray.
 - Name of registry
© 2010 Elsevier Ltd. All rights reserved.
- Registration number
Registration Registration number and name of registry.
0020–1383/$ – see front matter © 2010 Elsevier
Ltd. All rights reserved.
doi:10.1016/j.injury.2010.04.020
Tabel 2. Ceklist STARD khusus Abstrak Jurnal (Cohen et al., 2017).

C. Referensi Penilaian Jurnal

Bossuyt, P. M. et al. (2015) ‘STARD 2015 : an updated list of essential items for reporting diagnostic accuracy studies’, BMJ, 351, pp.
1–9. doi: 10.1136/bmj.h5527.
Cohen, J. F. et al. (2017) ‘STARD for Abstracts: essential items for reporting diagnostic accuracy studies in journal or conference
abstracts’, BMJ, 358, pp. 8–12. doi: 10.1136/bmj.j3751.