Expert Position Statement: Defining the Role of Intestinal Ultrasound in Assessing Constipation and Faecal Loading
Bibliographic record
Abstract
BACKGROUND: Intestinal ultrasound has been proposed as a tool to assess non-inflammatory functional gastrointestinal disorders, including constipation and faecal loading. However, well-defined sonographic criteria for these conditions are currently lacking. AIM: To identify and establish specific sonographic parameters that could be used to assess constipation and faecal loading with intestinal ultrasound. METHODS: We conducted a Research and Development/University of California Los Angeles appropriateness method exercise. A multidisciplinary, international panel comprising 14 experts in adult and paediatric gastroenterology and one radiologist experienced in gastrointestinal imaging rated the appropriateness of 57 statements using a 9-point Likert scale over two rounds of voting. Based on the median panel rating and level of disagreement, statements were categorised as appropriate, inappropriate or uncertain. RESULTS: 43 statements were deemed appropriate after two rounds of voting, while three were rated as inappropriate and five as uncertain. Intestinal ultrasound was determined to be an appropriate modality for the assessment of faecal loading. Posterior acoustic shadowing and echogenic reflections were considered important sonographic parameters for the assessment of faecal loading. A rectal diameter of 30 mm was considered appropriate to define faecal loading in paediatric patients, although no recommendation was made for adult patients due to a paucity of data. CONCLUSION: The expert panel considered intestinal ultrasound an appropriate modality for evaluating constipation and faecal loading. Further prospective research is required, especially in adult patients, to define sonographic metrics of luminal contents to broaden its application in the assessment of functional gastrointestinal disorders.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.038 | 0.102 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.015 | 0.009 |
| Insufficient payload (model declined to judge) | 0.006 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".