Assessment of cardiac pathology by point-of-care ultrasonography performed by a novice examiner is comparable to the gold standard

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Erik Sloth¹  Niels Holmark Andersen¹  Peter Juhl-Olsen¹  Christian Alcaraz Frederiksen¹ 

[1] Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

关键词: Heart disease;    Bedside;    Echocardiography;    Ultrasonography;    Point-of-care;   

Others  :  810509
DOI  :  10.1186/1757-7241-21-87

 received in 2013-07-28, accepted in 2013-12-10,  发布年份 2013

【 摘 要 】

Background

The aim of the study was to compare the diagnostic accuracy of point-of-care cardiac ultrasonography performed by a novice examiner against results from a specialist in cardiology with expert skills in echocardiography, with regard to the assessment of six clinically relevant cardiac conditions in a population of ward patients from the Department of Cardiology or the Department of Cardiothoracic Surgery.

Methods

Cardiac ultrasonography was performed by a novice examiner at the bedside and images were interpreted in a point-of-care context with dichotomous outcomes (yes/no). Six outcome categories were defined: 1) pericardial effusion (≥10 mm), 2) left ventricular dilatation (≥62 mm), 3) right ventricular dilatation (≥42 mm or ≥ left ventricular diameter), 4) left ventricular hypertrophy (≥13 mm), 5) left ventricular failure (EF ≤ 40%), 6) aortic stenosis (maximum flow velocity ≥3 m/s). The examiner was blinded to the patients’ medical history and results from previous echocardiographic examinations. Results from the interpreted point-of-care ultrasonography examination were compared with echocardiographic diagnosis made by a specialist in cardiology.

Results

A total of 102 medical and surgical patients were included. Assessments were made in six categories totalling 612 assessments. There was agreement between the novice examiner and the specialist in 95.6% of the cases; overall sensitivity was 0.91 and specificity was 0.97. Positive predictive value was 0.92 and negative predictive value was 0.97. Kappa statistics showed good agreement between observers (κ=0.88).

Conclusions

This study showed that a novice examiner was able to detect common and significant heart pathology in six different categories with good accuracy using POC ultrasonography.

【 授权许可】

   
2013 Frederiksen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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