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Focused cardiac ultrasound by unselected residents-the challenges

BMC medical imaging, 2017-03, Vol.17 (1), p.22-22, Article 22 [Peer Reviewed Journal]

COPYRIGHT 2017 BioMed Central Ltd. ;Copyright BioMed Central 2017 ;info:eu-repo/semantics/openAccess ;The Author(s). 2017 ;ISSN: 1471-2342 ;EISSN: 1471-2342 ;DOI: 10.1186/s12880-017-0191-y ;PMID: 28259149

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Title:
Focused cardiac ultrasound by unselected residents-the challenges
Author: Ruddox, Vidar ; Norum, Ingvild Billehaug ; Stokke, Thomas Muri ; Edvardsen, Thor ; Otterstad, Jan Erik
Subjects: Accreditation ; Accuracy ; After-Hours Care - statistics & numerical data ; Aged ; Aged, 80 and over ; Atrium ; Cardiology ; Cardiology - education ; Cardiovascular diseases ; Clinical Competence - statistics & numerical data ; Coronary artery disease ; Diagnosis ; Dyspnea ; Echocardiography ; Echocardiography - statistics & numerical data ; Edema ; Effusion ; Female ; Heart diseases ; Heart Diseases - diagnostic imaging ; Heart Diseases - epidemiology ; Heart failure ; Humans ; Inservice Training - statistics & numerical data ; Internal medicine ; Internship and Residency - statistics & numerical data ; Male ; Medical diagnosis ; Medical personnel ; Methods ; Middle Aged ; Norway - epidemiology ; Pain ; Prevalence ; Radiology - education ; Reproducibility of Results ; Respiration ; Sensitivity ; Sensitivity and Specificity ; Society ; Stroke Volume ; Training ; Ultrasonic imaging ; Ultrasound ; Ultrasound imaging ; Ventricle
Is Part Of: BMC medical imaging, 2017-03, Vol.17 (1), p.22-22, Article 22
Description: Focus Cardiac Ultrasound (FoCUS) performed by internal medicine residents on call with 2 h of training can provide a means for ruling out cardiac disease, but with poor sensitivity. The purpose of the present study was to evaluate diagnostic usefulness as well as diagnostic accuracy of FoCUS following 4 h of training. All residents on call were given a 4-h training course with an additional one-hour training course after 6 months. They were asked to provide a pre- and post-FoCUS diagnosis, with the final diagnosis at discharge as reference. During a 7 month period 113 FoCUS examinations were reported; after 53 were excluded this left 60 for evaluation with a standard echocardiogram performed on average 11.5 h after FoCUS. Examinations were performed on the basis of chest pain and dyspnoea/edema. The best sensitivity was found in terms of the detection of reduced left ventricular (LV) ejection fraction (EF) (92%), LV dilatation (85%) and pericardial effusion (100%). High values were noted for negative predictive values, although false positives were seen. A kappa > 0.6 was observed for reduced LVEF, right ventricular area fraction and dilatation of LV and left atrium. In 48% of patients pre- and post-FoCUS diagnoses were identical and concordant with the final diagnosis. Importantly, in 30% examinations FoCUS correctly changed the pre-FoCUS diagnosis. A FoCUS protocol with a 4-h training program gained clinical usefulness in one third of examinations. False positive findings represented the major challenge.
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1471-2342
EISSN: 1471-2342
DOI: 10.1186/s12880-017-0191-y
PMID: 28259149
Source: SpringerOpen
Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
NORA Norwegian Open Research Archives
PubMed Central
ROAD: Directory of Open Access Scholarly Resources
ProQuest Central
DOAJ Directory of Open Access Journals

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Focused cardiac ultrasound by unselected residents-the challenges

COPYRIGHT 2017 BioMed Central Ltd. ;Copyright BioMed Central 2017 ;info:eu-repo/semantics/openAccess ;The Author(s). 2017 ;ISSN: 1471-2342 ;EISSN: 1471-2342 ;DOI: 10.1186/s12880-017-0191-y ;PMID: 28259149

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