Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device
Background. The potential of pocket-sized ultrasound devices (PUDs) to improve global healthcare delivery is limited by the lack of a suitable imaging protocol and trained users. Therefore, we investigated the feasibility of performing a brief, evidence-based cardiac limited ultrasound exam (CLUE) t...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2013/627230 |
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| author | Tuan V. Mai David T. Ahn Colin T. Phillips Donna L. Agan Bruce J. Kimura |
| author_facet | Tuan V. Mai David T. Ahn Colin T. Phillips Donna L. Agan Bruce J. Kimura |
| author_sort | Tuan V. Mai |
| collection | DOAJ |
| description | Background. The potential of pocket-sized ultrasound devices (PUDs) to improve global healthcare delivery is limited by the lack of a suitable imaging protocol and trained users. Therefore, we investigated the feasibility of performing a brief, evidence-based cardiac limited ultrasound exam (CLUE) through wireless guidance of novice users. Methods. Three trainees applied PUDs on 27 subjects while directed by an off-site cardiologist to obtain a CLUE to screen for LV systolic dysfunction (LVSD), LA enlargement (LAE), ultrasound lung comets (ULC+), and elevated CVP (eCVP). Real-time remote audiovisual guidance and interpretation by the cardiologist were performed using the iPhone 4/iPod (FaceTime, Apple, Inc.) attached to the PUD and transmitted data wirelessly. Accuracy and technical quality of transmitted images were compared to on-site, gold-standard echo thresholds. Results. Novice versus sonographer imaging yielded technically adequate views in 122/135 (90%) versus 130/135 (96%) (). CLUE’s combined SN, SP, and ACC were 0.67, 0.96, and 0.90. Technical adequacy (%) and accuracy for each abnormality () were LVSD (85%, 0.93, ), LAE (89%, 0.74, ), ULC+ (100%, 0.94, ), and eCVP (78%, 0.91, ). Conclusion. A novice can perform the CLUE using PUD when wirelessly guided by an expert. This method could facilitate PUD use for off-site bedside medical decision making and triaging of patients. |
| format | Article |
| id | doaj-art-013fad3844a44f0e9c77c86b8f6d5966 |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-013fad3844a44f0e9c77c86b8f6d59662025-02-03T05:44:56ZengWileyEmergency Medicine International2090-28402090-28592013-01-01201310.1155/2013/627230627230Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound DeviceTuan V. Mai0David T. Ahn1Colin T. Phillips2Donna L. Agan3Bruce J. Kimura4Department of Graduate Medical Education, Scripps Mercy Hospital, 4077 Fifth Avenue, MER-35, San Diego, CA 92103, USADepartment of Graduate Medical Education, Scripps Mercy Hospital, 4077 Fifth Avenue, MER-35, San Diego, CA 92103, USADepartment of Graduate Medical Education, Scripps Mercy Hospital, 4077 Fifth Avenue, MER-35, San Diego, CA 92103, USADepartment of Graduate Medical Education, Scripps Mercy Hospital, 4077 Fifth Avenue, MER-35, San Diego, CA 92103, USADepartment of Graduate Medical Education, Scripps Mercy Hospital, 4077 Fifth Avenue, MER-35, San Diego, CA 92103, USABackground. The potential of pocket-sized ultrasound devices (PUDs) to improve global healthcare delivery is limited by the lack of a suitable imaging protocol and trained users. Therefore, we investigated the feasibility of performing a brief, evidence-based cardiac limited ultrasound exam (CLUE) through wireless guidance of novice users. Methods. Three trainees applied PUDs on 27 subjects while directed by an off-site cardiologist to obtain a CLUE to screen for LV systolic dysfunction (LVSD), LA enlargement (LAE), ultrasound lung comets (ULC+), and elevated CVP (eCVP). Real-time remote audiovisual guidance and interpretation by the cardiologist were performed using the iPhone 4/iPod (FaceTime, Apple, Inc.) attached to the PUD and transmitted data wirelessly. Accuracy and technical quality of transmitted images were compared to on-site, gold-standard echo thresholds. Results. Novice versus sonographer imaging yielded technically adequate views in 122/135 (90%) versus 130/135 (96%) (). CLUE’s combined SN, SP, and ACC were 0.67, 0.96, and 0.90. Technical adequacy (%) and accuracy for each abnormality () were LVSD (85%, 0.93, ), LAE (89%, 0.74, ), ULC+ (100%, 0.94, ), and eCVP (78%, 0.91, ). Conclusion. A novice can perform the CLUE using PUD when wirelessly guided by an expert. This method could facilitate PUD use for off-site bedside medical decision making and triaging of patients.http://dx.doi.org/10.1155/2013/627230 |
| spellingShingle | Tuan V. Mai David T. Ahn Colin T. Phillips Donna L. Agan Bruce J. Kimura Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device Emergency Medicine International |
| title | Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device |
| title_full | Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device |
| title_fullStr | Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device |
| title_full_unstemmed | Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device |
| title_short | Feasibility of Remote Real-Time Guidance of a Cardiac Examination Performed by Novices Using a Pocket-Sized Ultrasound Device |
| title_sort | feasibility of remote real time guidance of a cardiac examination performed by novices using a pocket sized ultrasound device |
| url | http://dx.doi.org/10.1155/2013/627230 |
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