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however&#44; it is a highly operator-dependent technique&#46; This dependency on the operator&#8217;s knowledge&#44; skills&#44; experience and competence is the greatest risk of indiscriminate use of a technique with such a high diagnostic capacity&#46; Therefore&#44; it is necessary to ensure that the professionals who perform ultrasounds have sufficient levels of training to be able to do so safely and effectively&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Training in ultrasound is included in the current training programme that must be completed by interns and resident physicians specialising in gastroenterology in Spain &#40;ministerial order SAS&#47;2854&#47;2009 of 9 October 2009&#41;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#59; which specifies that resident physicians must acquire sufficient knowledge and skills to be able to perform ultrasound in their professional practice&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">For this reason&#44; the Societat Catalana de Radiologia &#91;Catalan Society of Radiology&#93; and the Societat Catalana de Digestologia &#91;Catalan Society of Gastroenterology&#93; have agreed upon this working document&#46; The objective is to set out a framework with which to begin to meet some of the needs of gastroenterologists in their day-to-day clinical practice&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Obviously&#44; this document is not intended to meet every possible need that might arise&#44; but it does propose a number of clinical situations in which having an immediate answer available from a bedside&#47;office ultrasound would enable better and&#47;or more rapid diagnostic and therapeutic approaches to be adopted&#46; Under no circumstances would this examination eliminate the need for a formal ultrasound by specialists in radiology and diagnostic imaging when indicated&#46; Neither would it lead to orders for more complex examinations such as computed tomography &#40;CT&#41; or magnetic resonance imaging &#40;MRI&#41; without prior consultation with the radiology department&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">This document is intended to provide guidance on how the physicians in our two specialities could work in a coordinated manner&#46; However&#44; this must be established and agreed upon at each hospital individually based on the characteristics and particularities of each radiology and gastroenterology department&#46; The document is not executive in nature&#59; rather&#44; it consists of proposals and recommendations and has been approved by both boards of directors&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1010">Objectives</span><p id="par0040" class="elsevierStylePara elsevierViewall">This document is intended to achieve the following objectives&#58;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Primary objective</span><p id="par0045" class="elsevierStylePara elsevierViewall">To establish ultrasound as a supplementary tool for the diagnosis of certain diseases in the healthcare practice of gastroenterology specialists&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Specific objectives</span><p id="par0050" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0055" class="elsevierStylePara elsevierViewall">To determine the areas and types of ultrasound that could be performed by gastroenterologists&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0060" class="elsevierStylePara elsevierViewall">To propose the training programme that is necessary&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0065" class="elsevierStylePara elsevierViewall">To propose the potential training entities&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8226;</span><p id="par0070" class="elsevierStylePara elsevierViewall">To propose the minimal technical characteristics of the ultrasound systems&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8226;</span><p id="par0075" class="elsevierStylePara elsevierViewall">To propose a model for implementation&#46;</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Methodology</span><p id="par0080" class="elsevierStylePara elsevierViewall">A working group was formed&#44; consisting of three gastroenterologists and three diagnostic imaging specialists&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">This working group began its task in July 2019 with an initial meeting to exchange opinions on healthcare needs&#44; training needs&#44; and areas of action&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">After agreeing with the respective boards of the societies involved upon the need to prepare a working document&#44; a first draft of this consensus document was written&#46; This was initially prepared online&#44; amended as necessary and shared with the working group to agree upon the document&#46; Next&#44; an in-person working meeting was held &#40;in January 2020&#41; to resolve the more complex points&#44; primarily with regard to training&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Once all pertinent changes were finalised&#44; the definitive document was submitted to both the Societat Catalana de Radiologia and the Societat Catalana de Digestologia and was approved by both boards of directors&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1030">Definition of the scope of the project</span><p id="par0100" class="elsevierStylePara elsevierViewall">The scope of application of ultrasound as performed by gastroenterologists aims to provide an immediate answer in the consulting room or at the bedside &#40;when patients are hospitalised&#41; in situations in which&#44; <span class="elsevierStyleItalic">a priori</span>&#44; they may offer a greater benefit to the patient in terms of capacity for resolution and efficiency&#46; These situations may be summed up as follows&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">1</span><p id="par0105" class="elsevierStylePara elsevierViewall">In patients with jaundice&#44; in whom it is important to be able to diagnose bile duct dilatation &#40;whether inside or outside the liver&#47;common bile duct&#41; in order to triage emergency or priority orders for radiological examinations &#40;formal ultrasound&#41; and avoid emergency demand for ultrasounds in patients with intrahepatic cholestasis due to liver disease that is parenchymal or secondary to other causes not leading to bile duct dilatation&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">2</span><p id="par0110" class="elsevierStylePara elsevierViewall">In assessing for organomegaly &#40;hepatomegaly or splenomegaly&#41; and signs of portal hypertension &#40;assessing the restoration of blood flow to the paraumbilical vein&#41;&#46; We believe that the other signs of portal hypertension require extensive experience and that a formal ultrasound by a radiologist would be required to avoid false diagnoses&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">3</span><p id="par0115" class="elsevierStylePara elsevierViewall">In evaluating for ascites&#44; as it will enable diuretic treatment to be adjusted or guide a possible diagnostic paracentesis&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">4</span><p id="par0120" class="elsevierStylePara elsevierViewall">In guiding interventional procedures&#58; aspiration paracentesis&#44; aspiration thoracentesis and liver biopsy &#40;depending on the particularities of each centre&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">5</span><p id="par0125" class="elsevierStylePara elsevierViewall">In ruling out acute urinary retention&#44; to avoid unnecessary catheterisation&#46;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">6</span><p id="par0130" class="elsevierStylePara elsevierViewall">In cases in which FibroScan&#174; is challenging or its values do not correlate with the patient&#39;s clinical context&#44; an ultrasound can be performed in advance to assess the most suitable point for performing hepatic elastography &#40;assessing distance to liver parenchyma&#44; preventing cystic lesions and better assessing obese patients who will require an XL probe&#41;&#46; Alternatively&#44; shear wave elastography can be performed where the radiology department has this technique available&#46;</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Training of gastroenterologists in ultrasound</span><p id="par0135" class="elsevierStylePara elsevierViewall">The training proposal will be agreed upon between the departments involved at each hospital so that it may be adapted to their needs and possibilities&#46; In any case&#44; this document advises starting the training of one or two physicians attached to the gastroenterology department and&#44; at the same time&#44; gradually enhancing the training of the residents in this speciality&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Regarding the training of gastroenterology residents&#44; their training in ultrasound should be gradually adapted in accordance with the national programme for the speciality&#46; This working group proposes making a rotation in the abdominal ultrasound unit&#44; preferably during the second year of residency&#44; and lasting about 2 months&#44; so that they can perform around 200 abdominal examinations autonomously but under supervision&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">To unify the minimum training&#44; this tool proposes a set of knowledge and skills that should be acquired through the formation and training process&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;5</span></a></p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Basic competencies</span><p id="par0150" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">1</span><p id="par0155" class="elsevierStylePara elsevierViewall">To complete the training in performing ultrasound examinations in the clinical situations described in the areas of action where they may be useful at outpatient clinics&#44; day hospitals or at the patient&#39;s bedside&#46; All the ultrasound examinations will be recorded&#44; either in a report or in a case history &#40;depending on the electronic resources available at each centre&#41;&#59; it is necessary to clearly identify who performed the examination and its results&#44; as this is a medical act that carries responsibility&#46; It is recommended that images be digitally archived if possible&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">2</span><p id="par0160" class="elsevierStylePara elsevierViewall">To know the situations in which an ultrasound examination must be ordered to be performed by specialists in radiology and diagnostic imaging&#46;</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">3</span><p id="par0165" class="elsevierStylePara elsevierViewall">To acquire the technical skills to be able to correctly handle the ultrasound equipment in order to obtain diagnostic-quality images and to be able to perform the ultrasound-guided invasive procedures described above&#46;</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">4</span><p id="par0170" class="elsevierStylePara elsevierViewall">To participate in the necessary ongoing training activities to update knowledge and skills in order to maintain professional competency&#46;</p></li></ul></p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Specific objectives of the training programme</span><p id="par0175" class="elsevierStylePara elsevierViewall">The set of knowledge and skills that should be acquired through the formation and training process are described below&#46;</p><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Knowledge</span><p id="par0180" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">1</span><p id="par0185" class="elsevierStylePara elsevierViewall">To understand the ultrasound technique&#44; which includes knowing the basic physics of ultrasound&#44; how an ultrasound system works&#44; the technical parameters that influence image quality and the possible artefacts&#44; as well as how to correct them&#46; It is also necessary to know the artefacts that aid in diagnosis&#46;</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">2</span><p id="par0190" class="elsevierStylePara elsevierViewall">To know the indications&#44; non-indications&#44; limitations and preparation for the examination to be performed&#46;</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">3</span><p id="par0195" class="elsevierStylePara elsevierViewall">To identify normal ultrasound anatomy&#46;</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">4</span><p id="par0200" class="elsevierStylePara elsevierViewall">To identify basic ultrasound semiology&#46;</p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">5</span><p id="par0205" class="elsevierStylePara elsevierViewall">To identify the ultrasound findings possible within the clinical situations agreed upon in the scope of application of ultrasound by gastroenterologists&#46;</p></li><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">6</span><p id="par0210" class="elsevierStylePara elsevierViewall">To recognise lesions or images that require a more complex ultrasound performed by a diagnostic imaging specialist&#44; who should also be the person to guide clinicians regarding recommendation of more complex tests&#46;</p></li></ul></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Skills</span><p id="par0215" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">1</span><p id="par0220" class="elsevierStylePara elsevierViewall">To know how to technically handle the ultrasound system to obtain the best possible image&#46;</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">2</span><p id="par0225" class="elsevierStylePara elsevierViewall">To recognise ultrasound artefacts&#46;</p></li><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">3</span><p id="par0230" class="elsevierStylePara elsevierViewall">To know how to perform the following procedures&#58; ultrasound-guided thoracentesis and paracentesis&#44; and ultrasound-guided liver biopsy &#40;depending on the particularities of each centre&#41;&#46;</p></li></ul></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Training model</span><p id="par0235" class="elsevierStylePara elsevierViewall">The training proposal presented is divided into two sequential levels&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Level 1&#58;</span> Normal anatomical ultrasound &#40;20&#8239;h&#41;</p><p id="par0245" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Person responsible&#58;</span> assigned attending radiologist&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">This will take place face-to-face at each hospital&#59; arranging a suitable time for this with the radiology department&#44; in accordance with its training capacity&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">It will include&#58;</span><ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel">-</span><p id="par0260" class="elsevierStylePara elsevierViewall">A review of the functions of the specific ultrasound system that will be used in that session&#46;</p></li><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel">-</span><p id="par0265" class="elsevierStylePara elsevierViewall">A review of normal ultrasound anatomy on a real model&#46;</p></li><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">-</span><p id="par0270" class="elsevierStylePara elsevierViewall">Students will steadily develop their ability to perform a basic abdominal ultrasound and resolve any possible questions that may arise&#46; When students are capable of performing all ultrasound examination manoeuvres and obtaining clear images&#44; they will be assessed to proceed to ultrasound examinations in real clinical practice &#40;Level 2&#41;&#46;</p></li></ul></p><p id="par0275" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Level 2&#58;</span> Abdominal ultrasound under real clinical practice conditions</p><p id="par0280" class="elsevierStylePara elsevierViewall">Once students are capable of correctly performing a basic ultrasound examination&#44; at the discretion of the radiologist responsible&#44; they will initiate progressive learning of pathological images in ultrasound&#46; If possible&#44; in order to increase their knowledge&#44; provided that there is sufficient availability at the centre&#44; it is recommended that they assess cases already recorded with a previously identified condition&#46; In addition&#44; they will learn how to perform puncture techniques &#40;percutaneous liver biopsy &#91;PLB&#93;&#44; paracentesis&#44; thoracentesis&#44; etc&#46;&#41;&#44; and the indications for and use of the different types of material&#46;</p><p id="par0285" class="elsevierStylePara elsevierViewall">Finally&#44; students will increasingly autonomously&#44; but always under supervision&#44; perform ultrasounds with patients referred to the ultrasound unit to have an ultrasound done for a clinical reason&#44; with the student and the radiologist coming to an agreement on the findings of the examination&#59; thus the ultrasound findings of students and their monitors are consistent for students to gradually achieve the required level&#46; The students must show that the clinical&#47;radiological information that they derive from the ultrasound examination is consistent with that of their monitors&#46; In addition&#44; it is advisable for the physicians in training to maintain a record of the examinations that they perform&#46;</p><p id="par0290" class="elsevierStylePara elsevierViewall">Regarding puncture techniques&#44; the physician&#47;gastroenterologist should eventually acquire the knowledge and skills to be able to autonomously perform them in their work setting &#40;day hospital&#44; ward&#44; accident and emergency department&#44; etc&#46;&#41;&#46;</p><p id="par0295" class="elsevierStylePara elsevierViewall">Around 200 examinations overall are thought to be required to acquire this knowledge and skills&#46; Regarding therapeutic techniques&#44; it is considered necessary to perform at least 10 liver biopsies under supervision and another 10 autonomously &#40;at the centres where gastroenterologists perform them&#41;&#44; 5 paracenteses and 5 thoracenteses under supervision and the same number autonomously&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Ultrasound systems and technical characteristics</span><p id="par0300" class="elsevierStylePara elsevierViewall">The characteristics of the ultrasound systems are important&#44; in order to ensure that the images obtained are of suitable quality&#44; as well as the management&#44; storage and remote operation of these systems&#46; Many high-quality systems are available today&#46; To obtain a good image&#44; systems should be less than 10 years old&#44; with a multifrequency and colour Doppler convex probe &#40;Appendix B See Annex 1&#41;&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">Regarding consumable materials&#44; in performing either paracentesis or thoracentesis&#44; or in performing liver biopsy depending on the usual practice at each centre&#44; it is desirable for both the gastroenterology department and the diagnostic imaging department to use the same materials and the same work methodology&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Working document follow-up evaluation</span><p id="par0310" class="elsevierStylePara elsevierViewall">Given the initial difficulty of implementing changes in resident rotations&#44; having ultrasound systems available and achieving interdepartmental coordination&#44; we propose making a first assessment 2 years after approval of the working document&#46;</p><p id="par0315" class="elsevierStylePara elsevierViewall">This assessment will include the number of centres that have incorporated ultrasound at day hospitals&#44; outpatient clinics and the patient&#8217;s bedside&#44; the number of attending physicians in the gastroenterology department who perform this type of examination in each department&#59; and how the rotation in ultrasound has been implemented in the resident training period&#46; Any difficulties that may have arisen and any suggestions put to us by hospitals will also be included&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall">This document proposes that subsequent follow-up be decided upon depending on the outcomes of the first assessment&#46;</p><p id="par0325" class="elsevierStylePara elsevierViewall">In addition&#44; if the board of either of the two societies involved requests it&#44; an assessment will be conducted as soon as possible after the request&#46; In all cases&#44; a report will be issued and sent to both boards&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Funding</span><p id="par0330" class="elsevierStylePara elsevierViewall">No funding was received for this study&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0335" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Over recent years&#44; ultrasonography has been used increasingly in various medical specialties and is now an indispensable diagnostic tool&#46; In gastroenterology&#44; bedside or point-of-care ultrasound allows the early diagnosis and monitoring of multiple intraabdominal conditions&#46; Ultrasound guidance is also highly useful in certain therapeutic procedures&#44; increasing procedural safety&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ultrasound is a non-invasive technique but has the drawback of being very operator dependent&#46; Therefore&#44; it is necessary to ensure that the professionals who perform ultrasonography have a sufficient level of training in the technique&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In Catalonia&#44; abdominal ultrasound is usually carried out by radiologists and has not yet been incorporated as an investigation performed by gastroenterologists&#46; In view of this&#44; the <span class="elsevierStyleItalic">Societat Catalana de Radiologia</span> and the <span class="elsevierStyleItalic">Societat Catalana de Digestologia</span> judged it necessary to develop a consensus framework document on ultrasound use and training for gastroenterologists&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The document establishes the suggested format for training&#44; the appropriate indications&#44; the minimum material requirements and appropriate documentation of the procedure to ensure that gastroenterologist-performed ultrasound is useful and safe&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar1020" class="elsevierStyleSimplePara elsevierViewall">Desde hace a&#241;os y de manera progresiva&#44; la ecograf&#237;a se ha incorporado en las diferentes especialidades m&#233;dicas como una herramienta necesaria e indispensable&#46; En patolog&#237;a digestiva la ecograf&#237;a abdominal a pie de cama o inmediata permite el diagn&#243;stico r&#225;pido y&#47;o el seguimiento de distintas patolog&#237;as intraabdominales&#46; Por otro lado&#44; la ecograf&#237;a es muy &#250;til como gu&#237;a en determinados procedimientos intervencionistas dado que comporta una mayor seguridad&#46;</p><p id="spar7010" class="elsevierStyleSimplePara elsevierViewall">A pesar de ser una t&#233;cnica no invasiva&#44; la ecograf&#237;a tiene el inconveniente de ser muy operador dependiente&#44; por lo que es necesario garantizar que aquellos profesionales que realicen ecograf&#237;as dispongan del suficiente nivel de capacitaci&#243;n t&#233;cnica&#46;</p><p id="spar6015" class="elsevierStyleSimplePara elsevierViewall">En Catalunya&#44; tradicionalmente la ecograf&#237;a digestiva es una t&#233;cnica que es llevada a cabo por el servicio de radiolog&#237;a y&#44; todav&#237;a no se ha incorporado como herramienta en la especialidad en Ap&#46; Digestivo&#46; En este contexto&#44; la Societat Catalana de Radiologia y la Societat Catalana de Digestologia han considerado necesaria la redacci&#243;n de un documento marco&#44; consensuado&#44; sobre la utilizaci&#243;n y aprendizaje de la ecograf&#237;a por especialistas en el aparato digestivo&#46;</p><p id="spar5020" class="elsevierStyleSimplePara elsevierViewall">El documento establece&#58; como deber&#237;a ser la formaci&#243;n&#44; en que indicaciones&#44; que requerimientos m&#237;nimos de material y como debe documentarse la exploraci&#243;n para que la ecograf&#237;a realizada por el especialista de digestivo sea &#250;til y segura&#46;</p></span>"
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                  "referenciaCompleta" => "College of Radiology&#44; A&#46; &#40;nd&#41;&#46; ACR&#8211;AIUM&#8211;SPR&#8211;SRU Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and&#47;or Retroperitoneum&#46;"
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                      "titulo" => "Good practice for radiological reporting&#46; Guidelines from the European Society of Radiology &#40;ESR&#41;"
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                  "referenciaCompleta" => "Morales A&#44; del Cura JL&#44; Bueno A&#44; Remart&#237;nez E&#44; Garcia B&#44; M&#233;ndez S&#46; Mart&#237;nez S&#44; Garc&#237;a P&#44; Pelayo M&#44; Nicolau C&#44; G&#46;M&#46; S&#46; 2013-03&#46; M&#46;S&#46; E&#46; de U&#46; S&#46; 2013&#46; &#40;2013&#41;&#46; El informe en ecograf&#237;a-1&#46;pdf &#40;p&#46; 6&#41;&#46; Sociedad Espa&#241;ola de Ultrasonidos SEUS 2013&#46;"
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