Feasibility and Diagnostic Accuracy of Point-of-Care Abdominal Sonography by Pocket-Sized Imaging Devices, Performed by Medical Residents

J Ultrasound Med. 2017 Jun;36(6):1195-1202. doi: 10.7863/ultra.16.05077. Epub 2017 Feb 28.

Abstract

Objectives: We aimed to study the feasibility and diagnostic performance of bedside ultrasound by examination of the liver, gallbladder, kidneys, and abdominal aorta performed by medical residents with limited experience in ultrasound, on emergency admissions using pocket-sized imaging devices (PSIDs).

Methods: A total of 199 patients admitted acutely to the medical department at the non-university Levanger Hospital, Norway, during the period from April 4 to June 23, 2011, were consecutively included. Six medical residents, selected by drawing, examined these patients with a PSID at admission. Reference imaging was performed and/or judged at the Department of Radiology.

Results: Each resident performed a median of 28 examinations (interquartile range 24-46). Imaging of the kidneys and liver were feasible in 85 and 82% of the cases, and the corresponding values for the gallbladder and abdominal aorta were 79 and 50%, respectively. The sensitivity of medical residents to detect organ pathology with the aid of PSID, ranged between 54% (95% confidence interval [CI]: 29-77%) and 74% (95% CI: 51-88%). Assessment of the aortic dimension showed moderate correlation, with r = 0.38.

Conclusions: Examination by PSID by inexperienced residents may allow for early detection of abdominal pathology, but do not appear to be accurate enough to rule out pathology in the abdominal organs.

Keywords: bedside; education; hand-held; non-experts; pocket-size; point-of-care ultrasound.

MeSH terms

  • Abdomen / diagnostic imaging*
  • Aged
  • Clinical Competence / statistics & numerical data*
  • Diagnosis, Differential
  • Educational Measurement / statistics & numerical data
  • Equipment Design
  • Feasibility Studies
  • Female
  • Humans
  • Internship and Residency / statistics & numerical data*
  • Male
  • Miniaturization
  • Norway / epidemiology
  • Point-of-Care Systems / statistics & numerical data*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Ultrasonography / instrumentation*
  • Ultrasonography / statistics & numerical data*