Use and impact of point-of-care ultrasonography in general practice: a prospective observational study

Andersen, Camilla Aakjær; Brodersen, John; Davidsen, Annette Sofie; Graumann, Ole; Jensen, Martin Bach

doi:10.1136/bmjopen-2020-037664

Cited by 37 publications

(35 citation statements)

References 22 publications

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“…Naturally, interns feel it convenient to consult staff. Our survey showed all POCUS examinations were performed for diagnostic purposes which were also consistent with the previous studies [12] which showed the primary aim of performing POCUS was to confirm or disconfirm a specific clinical condition (73.1%). However, some studies [11] illustrated POCUS was used to aid physicians in performing procedureguided ultrasound.…”

Section: Discussionsupporting

confidence: 89%

Point of Care Ultrasound Use by Interns in Emergency Department

Ienghong

Suzuki

Tiamkao

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: Point of care ultrasound (POCUS) is required for use in many instances on a daily basis in the hospital, especially in the emergency department and other specialty treatment areas. While interns play a crucial role in running emergency services in Thailand, the POCUS usage of interns has not been well studied. METHODS: This was a retrospective observational study of the interns who worked at the Department of Emergency Medicine, a tertiary university hospital in Khon Kaen, Thailand between July 2020 and April 2021. The seven questions survey about participants’ experiences performing POCUS examinations was conceived and carried out by the research team. The primary aim of this study is to identify the frequency of POCUS examinations performed by interns in this or any other given rotation. RESULTS: The response rate was 81.25% with the frequency of POCUS examinations per physician coming in at 2.5 per shift. It should be noted that examinations occurred primarily during the morning shift (79%) and were for diagnostic purposes (100%). The highest POCUS use cases (80%) were found to take place for abdominal examinations and the most commonly used POCUS application was the FAST (Focused Assessment with Sonography for Trauma) examination (92%). The confidence level was rated as 3/5. The primary barrier to performing POCUS was lack of knowledge or ultrasound training (47%). CONCLUSIONS: POCUS is often used by interns though less than in some other specialties. The type of POCUS application employed was limited due to lack of training and the primary obstacle for POCUS use in the emergency department was patient overcrowding.

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Section: Discussionsupporting

confidence: 89%

Point of Care Ultrasound Use by Interns in Emergency Department

Ienghong

Suzuki

Tiamkao

et al. 2021

Open Access Maced J Med Sci

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“…Recently, a systematic review showed that POCUS is being used frequently in the primary care setting for diagnostic, screening, and procedural use [3]. Additionally, one study has shown that POCUS can influence the diagnostic process in the primary care setting by increasing the confidence of diagnosis and changing management plans [4]. In the inpatient setting, one study has shown that POCUS used during ward emergencies was associated with a shorter time to intervention and decreased mortality when compared to a control group [5].…”

Section: Discussionmentioning

confidence: 99%

Diagnosing Early Cardiac Tamponade in Patient with JAK2+ Myeloproliferative Syndrome with Point of Care Ultrasound

Cameron

Istrail

2021

pocus

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Point of care ultrasound (POCUS) is a diagnostic modality growing in popularity and use in medicine in both the acute and chronic management settings. Its utility lies in its non-invasive application, direct user interface, and portability, especially in handheld devices, allowing for quick assessment and triage. Herein is a case of POCUS diagnosing life threatening cardiac tamponade in a patient with a new diagnosis of JAK2+ myeloproliferative syndrome prompting urgent intervention with pericardiocentesis. This case illustrates the utility of POCUS through its ability to serve as a quick diagnostic tool that can hasten intervention for potentially life-threatening conditions.

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“…At the private gynaecologist, the patients can either be clinically managed or be further referred to the hospital. Thus in the intervention, the clinical management of the patients can be completed at the GP, the private gynaecologist, or at the gynaecological department in the hospital [ 24 ]. The completion is denoted with a terminal node.…”

Section: Methodsmentioning

confidence: 99%

“…The cost of ultrasonography scanner and POCUS training are both estimated using depreciation [ 24 , 28 , 29 ]. The cost of having an ultrasonography scanner to examine the patients per scanning is calculated using an average price of an ultrasonography scanner of €15,508.70, the percentage of patients with vaginal bleeding in early pregnancy, an average lifespan of seven years, an interest rate of 4%, and an annual number of ultrasonography scannings of 2.4 per GP.…”

Section: Methodsmentioning

confidence: 99%

A cost-minimisation analysis of performing point-of-care ultrasonography on patients with vaginal bleeding in early pregnancy in general practice: a decision analytical model

Kiritharan

Johanson²,

Jensen³

et al. 2022

BMC Health Serv Res

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Background Spotting and light vaginal bleeding are common and usually harmless symptoms in early pregnancy. Still, vaginal bleeding may be the first sign of an abortion and often causes distress to pregnant women and leads to an expectation of an ultrasonography examination of the uterus. As point-of-care ultrasonography (POCUS) is increasingly being integrated into general practice, these patients may be clinically evaluated and managed by general practitioners (GPs). This can potentially reduce referrals of patients from the primary to the secondary healthcare sector resulting in societal cost-savings. The primary purpose of this study was to investigate whether the accessibility of POCUS in general practice for patients with vaginal bleeding in early pregnancy is cost-saving compared to usual practice where GPs do not have access to POCUS. A secondary purpose of this study was to estimate a remuneration for GPs performing POCUS on these patients in general practice. Methods A cost-minimisation analysis was based on a decision tree model reflecting the two alternatives: general practice with and without GPs having access to POCUS. The robustness of the model results was investigated using probabilistic sensitivity analysis and the following deterministic sensitivity analyses: one-way analyses for the model input parameters and a scenario analysis with a change from a societal to a healthcare sector perspective. An expected remuneration reflecting the add-on cost of Danish GPs performing POCUS was estimated based on the related costs: cost of an ultrasonography scanner, GP’s time consumption, ultrasonography training, and utensils per scanning. Results The difference in average cost between the two alternatives from a societal perspective was estimated to be €110, in favour of general practice with GPs using POCUS. The deterministic sensitivity analyses demonstrated robustness of the results to plausible changes in the input parameters. The expected remuneration for performing POCUS in this specific setting was estimated to be €32 per examination. Conclusion Having GPs perform POCUS on patients with vaginal bleeding in early pregnancy is cost-saving compared to usual practice. The results should be taken with caution as this study was based on early modelling with uncertainties associated with the input parameters in the model.

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Use and impact of point-of-care ultrasonography in general practice: a prospective observational study

Cited by 37 publications

References 22 publications

Point of Care Ultrasound Use by Interns in Emergency Department

Point of Care Ultrasound Use by Interns in Emergency Department

Diagnosing Early Cardiac Tamponade in Patient with JAK2+ Myeloproliferative Syndrome with Point of Care Ultrasound

A cost-minimisation analysis of performing point-of-care ultrasonography on patients with vaginal bleeding in early pregnancy in general practice: a decision analytical model

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