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A Pilot Study of the Clinical Impact of Hand‐Carried Cardiac Ultrasound in the Medical Clinic
Author(s) -
Croft Lori B.,
Duvall W. Lane,
Goldman Martin E.
Publication year - 2006
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2006.00240.x
Subject(s) - medicine , echo (communications protocol) , physical examination , cardiac ultrasound , ultrasound , medical history , radiology , point of care ultrasound , computer science , computer network
Background: Small, hand‐carried ultrasound devices have become widely available, making point‐of‐care echocardiograms (echos) accessible to all medical personnel as a means to augment and improve the increasingly inefficient physical examination. This study was designed to determine the clinical utility of hand‐carried echo by medical residents in clinical decision making. Methods: Nine residents underwent brief, practical echo training to perform and interpret a limited hand‐carried echo as an integral component of their office examination. The residents' hand‐carried echo consisting of four basic views to define left ventricular (LV) function and wall thickness, valvular disease, and any pericardial effusions was compared to one performed by a level III echocardiographer. Results: Seventy‐two consecutive medical clinic patients were enrolled with an average image acquisition time of 4.45 minutes. Residents obtained diagnostic images in 94% of the cases and interpreted them correctly 93% of the time. They correctly identified 92% of the major echo findings and 78% of the minor findings. Their diagnosis of LV dysfunction, valvular disease, and LV hypertrophy improved by 19%, 39%, and 14% with hand‐carried echo compared to history and physical alone. Management decisions were reinforced in 76% and changed in 40% of patients with the use of hand‐carried echo. Conclusion: This study demonstrates that it is possible to train medical residents to perform an effective and reasonably accurate hand‐carried echo during their physical examination, which can impact clinical management.