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Feasibility of point-of-care echocardiography by internal medicine house staff.

Publication ,  Journal Article
Alexander, JH; Peterson, ED; Chen, AY; Harding, TM; Adams, DB; Kisslo, JA
Published in: Am Heart J
March 2004

OBJECTIVE: To determine whether internal medicine house staff with limited training in echocardiography can use point-of-care echocardiography to make simple, clinically important diagnoses. BACKGROUND: Availability of small, portable ultrasound devices could make point-of-care echocardiography widely available. The training required to perform point-of-care echocardiography has not been established. METHODS: Medical house staff participated in a 3-hour point-of-care echocardiography training program. Patients scheduled for standard echocardiography as part of clinical care underwent point-of-care echocardiography within 24 hours to assess four common clinically important diagnoses. Each standard echocardiogram was interpreted twice. Agreement (kappa) was calculated between point-of-care and standard echocardiography by using standard echocardiography as the gold standard and between the two interpretations of standard echocardiography. RESULTS: Agreement (kappa) between point-of-care echocardiography and standard echocardiography was 75% (0.51) for left ventricular dysfunction (ejection fraction <55%), 79% (0.31) for moderate or severe mitral regurgitation, 92% (0.32) for aortic valve thickening or immobility, and 98% (0.51) for moderate or large pericardial effusion. Agreement between the two interpretations of standard echocardiography was 83% (0.63) for left ventricular dysfunction, 92% (0.68) for moderate or severe mitral regurgitation, 95% (0.62) for aortic valve thickening or immobility, and 97% (0.53) for moderate or large pericardial effusion. CONCLUSIONS: Medical house staff with limited training in echocardiography can use point-of-care echocardiography to assess left ventricular function and pericardial effusion with moderate accuracy that is lower than that of standard echocardiography. Assessment of valvular disease and other diagnoses likely requires more training and/or experience in echocardiography.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

March 2004

Volume

147

Issue

3

Start / End Page

476 / 481

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Pulmonary Disease, Chronic Obstructive
  • Point-of-Care Systems
  • Pericardial Effusion
  • North Carolina
  • Middle Aged
  • Medical Staff, Hospital
  • Male
  • Internal Medicine
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Alexander, J. H., Peterson, E. D., Chen, A. Y., Harding, T. M., Adams, D. B., & Kisslo, J. A. (2004). Feasibility of point-of-care echocardiography by internal medicine house staff. Am Heart J, 147(3), 476–481. https://doi.org/10.1016/j.ahj.2003.10.010
Alexander, John H., Eric D. Peterson, Anita Y. Chen, Tina M. Harding, David B. Adams, and Joseph A. Kisslo. “Feasibility of point-of-care echocardiography by internal medicine house staff.Am Heart J 147, no. 3 (March 2004): 476–81. https://doi.org/10.1016/j.ahj.2003.10.010.
Alexander JH, Peterson ED, Chen AY, Harding TM, Adams DB, Kisslo JA. Feasibility of point-of-care echocardiography by internal medicine house staff. Am Heart J. 2004 Mar;147(3):476–81.
Alexander, John H., et al. “Feasibility of point-of-care echocardiography by internal medicine house staff.Am Heart J, vol. 147, no. 3, Mar. 2004, pp. 476–81. Pubmed, doi:10.1016/j.ahj.2003.10.010.
Alexander JH, Peterson ED, Chen AY, Harding TM, Adams DB, Kisslo JA. Feasibility of point-of-care echocardiography by internal medicine house staff. Am Heart J. 2004 Mar;147(3):476–481.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

March 2004

Volume

147

Issue

3

Start / End Page

476 / 481

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Pulmonary Disease, Chronic Obstructive
  • Point-of-Care Systems
  • Pericardial Effusion
  • North Carolina
  • Middle Aged
  • Medical Staff, Hospital
  • Male
  • Internal Medicine
  • Humans