Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation

Evangelista, Arturo; Galuppo, Valentina; Méndez, Judith; Evangelista, Lidia; Arpal, Lidia; Rubio, Carlos; Vergara, Montserrat Vargas; Liceran, Manuela; López, Francesc; Sales, Carlos; Miralles, Vicens; Galinsoga, Anna; Pérez, J. Asensi; Arteaga, Mercedes; Salvador, Betlem; López, Carlos González; Garcı́a-Dorado, David

doi:10.1136/heartjnl-2015-308421

Cited by 64 publications

(55 citation statements)

References 28 publications

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“…This is similar to previous data, in which a 68% decrease of indications of conventional echocardiography was achieved through handheld echocardiography in PC 17. These data suggest task sharing of echocardiography in the PC system may both be cost-saving and optimise resource utilisation by decreasing unnecessary referrals and prioritising high-risk patients.…”

Section: Discussionsupporting

confidence: 89%

“…In the PC setting, similar approaches have proven to be feasible. Evangelista et al reported a small proportion of handheld images (8.8%) as suboptimal for interpretation, a considerable decrease of referrals for conventional echocardiography and an increase of discharges, suggesting this strategy may be cost-saving 17. Our study protocol was even less expensive, as the images were also acquired by non-physicians.…”

Section: Discussionmentioning

confidence: 87%

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Integration of echocardiographic screening by non-physicians with remote reading in primary care

Nascimento

Beaton

Nunes

et al. 2018

Heart

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 87%

Integration of echocardiographic screening by non-physicians with remote reading in primary care

Nascimento

Beaton

Nunes

et al. 2018

Heart

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“…47,57,58 Limited cardiac examinations 20,52 also had a higher quality estimate than more extensive examinations. 27,39,67 Several articles 17,63,64 have reported an improvement in diagnostic accuracy of ultrasonography with training, but we found no overall association between the amount of training and diagnostic accuracy (Supplemental Appendix 5).…”

Section: Quality Of Scansmentioning

confidence: 70%

Point-of-Care Ultrasound in General Practice: A Systematic Review

et al. 2019

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PURPOSE Ultrasound examinations are currently being implemented in general practice. This study aimed to systematically review the literature on the training in and use of point-of-care ultrasound (POCUS) by general practitioners. METHODSWe followed the Cochrane guidelines for conduct and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting. We searched the databases MEDLINE (via PubMed), EMBASE, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials using the key words ultrasonography and general practice in combination and using thesaurus terms. Two reviewers independently screened articles for inclusion, extracted data, and assessed the quality of included studies using an established checklist. RESULTSWe included in our review a total of 51 full-text articles. POCUS was applied for a variety of purposes, with the majority of scans focused on abdominal and obstetric indications. The length of training programs varied from 2 to 320 hours. Competence in some types of focused ultrasound scans could be attained with only few hours of training. Focused POCUS scans were reported to have a higher diagnostic accuracy and be associated with less harm than more comprehensive scans or screening scans. The included studies were of a low quality, however, mainly because of issues with design and reporting.CONCLUSIONS POCUS has the potential to be an important tool for the general practitioner and may possibly reduce health care costs. Future research should aim to assess the quality of ultrasound scans in broader groups of general practitioners, further explore how these clinicians should be trained, and evaluate the clinical course of patients who undergo scanning by general practitioners.Annals Journal Club selection; see inside back cover or http://www.Ann FamMed.org/AJC/.To read or post commentaries in response to this article, see it online at http://www.AnnFamMed.org/content/17/1/61.

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“…Evangelista et al [16] have claimed that handheld ultrasound performed at the point of care by family doctors, with remote expert support interpretation using a web-based system, is feasible, rapid, and useful for detect-ing significant echocardiographic abnormalities and decreasing the number of unnecessary echocardiographic tests. a good knowledge of ultrasound scanning techniques among family physicians could help cut the cost of medical care, since family physicians' ability to interpret the results correctly would most probably reduce the number of improper referrals to specialists [3].…”

Section: Introductionmentioning

confidence: 99%

Experiences of family physicians after a CME ultrasound course

Szwamel¹,

Polański²,

Kurpas³

2017

fmpcr

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Background. Ultrasonography is an inexpensive, safe, noninvasive tool for obtaining diagnoses without performing further imaging tests, and for the timely referral of patients to further diagnosis or specialist care. Objectives. to determine which ultrasound tests are most often performed by family physicians, and what factors contribute to their use of ultrasound imaging. Material and methods. this survey-based study using the authors' questionnaire was conducted in March 2016 among 81 primary care physicians who had completed weekend courses on ultrasound abdominal cavity imaging. Results. Family physicians most often took ultrasounds of the abdominal cavity (35/50; 70%) and thyroid gland (35/50, 12%). the odds of an ultrasound being performed at primary care centers with at least two physicians with the necessary skills were about 29.29 times higher than at centers with less than two skilled physicians (or 29.29, 95% Ci 3.77, 1347.92). Family physicians (46/81; 56.79%) referred 274 patients for further specialist diagnosis. the diagnosis of neoplastic disease was confirmed in 168 cases (168/274; 61.31%). the anomalies that were most often detected by family physicians using ultrasound imaging included: cholelithiasis (24/50; 48%), renal cysts (16/50; 32%), nephrolithiasis (5/50; 10%), aortic aneurysms (2/50; 4%). Conclusions. Family physicians' ability to perform ultrasound scans increases the probability of other doctors acquiring this skill. Weekend courses for family physicians significantly shorten patients' waiting time for such examinations. a network of professional and upto-date workshops improving the practical skills of family physicians in ultrasound diagnostics, as well as peer review groups focused on ultrasound diagnostics performed by family physicians, are recommended. Key words: Primary health care, ultrasonography, physicians, family. szwamel k, Polański P, kurpas D. Experiences of family physicians after a CME ultrasound course.

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Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation

Abstract: HCU performed at the point of care by FDs with remote expert support interpretation using a web-based system is feasible, rapid and useful for detecting significant echocardiographic abnormalities and reducing the number of unnecessary echocardiographic studies.

Cited by 64 publications

References 28 publications

Integration of echocardiographic screening by non-physicians with remote reading in primary care

Integration of echocardiographic screening by non-physicians with remote reading in primary care

Point-of-Care Ultrasound in General Practice: A Systematic Review

Experiences of family physicians after a CME ultrasound course

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