Pocket-Sized Ultrasound as an Aid to Physical Diagnosis for Internal Medicine Residents: A Randomized Trial

The Use of Handheld Ultrasound Devices – An EFSUMB Position Paper

“…The clinical trials published on abdominal HHUSDs generally fall into one of four groups: gastroenterology, gynecology, urology and abdominal aortic ultrasound. Most of the articles on HHUSDs in gastroenterology and related fields focus on tentative diagnosis and triage of acutely ill patients or on assessments of ascites for paracentesis [8,9,11,12].…”

Ultrasound handheld devices – potential problems and possible solutions

“…A recent study found that pocket-sized ultrasound showed poor diagnostic accuracy and confidence when given to internal medicine residents after a 3 hour training session and 1 month of independent practice, highlighting the need for proper training [12].…”

Pocket-sized Ultrasound for Physical Diagnosis

“…1 While other studies have shown the feasibility of implementing point-of-care ultrasound curricula for internal medicine residents, the trial by Ojeda et al had disappointing results. 2 Several key factors were likely contributory.…”

“…In the trial by Ojeda et al, the pathology of the study participants was particularly limited. 1 The cardiac conditions listed in Table 1 of the article included structural heart disease and many valvular abnormalities, but pericardial effusion and left ventricular systolic dysfunction were not included. This choice is puzzling, since clinicians with limited training in point-of-care ultrasound have previously been shown to detect left ventricular systolic dysfunction and pericardial effusions, but not valvular heart disease.…”

“…4 Of the 17 physical exam abnormalities listed in Table 1, only three were abdominal pathologies (hepatomegaly, splenomegaly, and ascites). 1 The authors stratified their data by "organ system," but did not provide results for each specific abnormality. Assessing for organomegaly might be a more advanced skill than the binary question of whether ascites is present or absent; the reader is left wondering if the intervention group detected ascites reliably even if organomegaly was not well diagnosed.…”