Appendix B.

Agreement statistics among the 4 internists who reviewed the individual cases.

Assessment	Majority agreement					Disagreement	Findings in cases of disagreement	Fleiss Kappa
Thoracic radiographs
ODU			48 out of 50			2 out of 50	Mediastinal fat or sternal lymphadenopathy, cholecystoliths, hepatomegaly (n = 1); mild sternal lymphadenoapthy, cholecystoliths (n = 1).	κ = 0.72
		Useful		Not Useful
		10 out of 48		38 out of 48
DUS			47 out of 50			3 out of 50 (*All disagreement between category 2 and category 3)	Mild left atrial enlargement, metallic gastric foreign bodies (n = 1); mild sternal lymphadenopathy, cholecytoliths (n = 1); generalized cardiomegaly, mild pleural effusion (n = 1).	κ = 0.67
	Category 1	Category 2	Category 3	Category 4	Category 5
	0 out of 48	8 out of 48	5 out of 48	0 out of 48	34 out of 48
Abdominal ultrasound
ODU			55 out of 63			8 out of 63	Gall bladder wall edema (n = 1), hypoechoic liver (n = 1), splenomegaly (n = 1), cholecystitis (n = 1), hepatic nodules (n = 3), mottled liver (n = 1), heptomegaly (n = 2), mild peritoneal effusion (n = 2), decreased corticomedullary distinction (n = 1), gall bladder sludge (n = 1), cystic calculi (n = 1), cholecystolith (n = 1).	κ = 0.25
		Useful		Not Useful
		23 out of 63		33 out of 63
DUS			54 out of 63			9 out of 63 (*All disagreement between category 2 and category 3)	Splenomegaly (n = 2), hepatomegaly (n = 2), urine sedmimentation (n = 1), gall bladder sludge (n = 1), hepatic nodules (n = 5), decreased corticomedullary distinction (n = 1), mild peritoneal effusion (n = 1), hyperechoic liver (n = 2), hypoechoic spleen (n = 1), gall bladder wall edema (n = 2), mild pyelectasia (n = 1), splenic nodule (n = 2), mottled liver (n = 1), thrombus in splenic vein (n = 1), cholecystitis (n = 1), enlarged right lobe of the pancreas (n = 1), renal cyst (n = 2), cystitis (n = 1), cholelithiasis (n = 1).	κ = 0.31
	Category 1	Category 2	Category 3	Category 4	Category 5
	0 out of 63	14 out of 63	23 out of 63	0 out of 63	17 out of 63