Diagnostic influence of cardiovascular screening by pocket-size ultrasound in a cardiac unit

We aimed to study the diagnostic influence of adding a routine cardiovascular ultrasound screening of the cardiac anatomy and function, the pericardium, the pleura and the abdominal great vessels by the new pocket-size ultrasound device (pUS) with grey scale and colour Doppler imaging. In 119 random...

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Published inEuropean journal of echocardiography Vol. 12; no. 10; pp. 737 - 743
Main Authors Skjetne, Kyrre, Graven, Torbjørn, Haugen, Bjørn Olav, Salvesen, Øyvind, Kleinau, Jens Olaf, Dalen, Håvard
Format Journal Article
LanguageEnglish
Published England Oxford University Press 01.10.2011
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ISSN1532-2114
1525-2167
1532-2114
DOI10.1093/ejechocard/jer111

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Abstract We aimed to study the diagnostic influence of adding a routine cardiovascular ultrasound screening of the cardiac anatomy and function, the pericardium, the pleura and the abdominal great vessels by the new pocket-size ultrasound device (pUS) with grey scale and colour Doppler imaging. In 119 randomly selected patients admitted to a cardiac unit at a non-university hospital, routinely adding a cardiovascular ultrasonography of only 4.4 min with a pocket-size device corrected the primary diagnosis in 16% of patients. In addition, 29% had the primary diagnosis verified and in 10% an additional important diagnosis was made. Higher age predicted any diagnostic influence of pUS screening with an increase of 61% (P=0.003) per 10 years of higher age. Overall, the pUS screening had a sensitivity and specificity with respect to detecting at least moderate pathology of 97 and 93%. Positive and negative predictive values were 93 and 87%, respectively. In the sub-group of subjects with a change in the primary diagnosis following pUS there was no false-negative or false-positive findings. Screening by pUS assessed vascular and cardiac anatomy and function accurately and enabled correction of the diagnosis in 16% of patients admitted to a cardiac unit. In 55% of the participants, the cardiovascular ultrasound screening had important diagnostic influence. We suggest that it would be appropriate to implement strategies and systems for routinely adding an ultrasound cardiovascular examination to patients in cardiac units.
AbstractList We aimed to study the diagnostic influence of adding a routine cardiovascular ultrasound screening of the cardiac anatomy and function, the pericardium, the pleura and the abdominal great vessels by the new pocket-size ultrasound device (pUS) with grey scale and colour Doppler imaging.AIMSWe aimed to study the diagnostic influence of adding a routine cardiovascular ultrasound screening of the cardiac anatomy and function, the pericardium, the pleura and the abdominal great vessels by the new pocket-size ultrasound device (pUS) with grey scale and colour Doppler imaging.In 119 randomly selected patients admitted to a cardiac unit at a non-university hospital, routinely adding a cardiovascular ultrasonography of only 4.4 min with a pocket-size device corrected the primary diagnosis in 16% of patients. In addition, 29% had the primary diagnosis verified and in 10% an additional important diagnosis was made. Higher age predicted any diagnostic influence of pUS screening with an increase of 61% (P=0.003) per 10 years of higher age. Overall, the pUS screening had a sensitivity and specificity with respect to detecting at least moderate pathology of 97 and 93%. Positive and negative predictive values were 93 and 87%, respectively. In the sub-group of subjects with a change in the primary diagnosis following pUS there was no false-negative or false-positive findings.METHODS AND RESULTSIn 119 randomly selected patients admitted to a cardiac unit at a non-university hospital, routinely adding a cardiovascular ultrasonography of only 4.4 min with a pocket-size device corrected the primary diagnosis in 16% of patients. In addition, 29% had the primary diagnosis verified and in 10% an additional important diagnosis was made. Higher age predicted any diagnostic influence of pUS screening with an increase of 61% (P=0.003) per 10 years of higher age. Overall, the pUS screening had a sensitivity and specificity with respect to detecting at least moderate pathology of 97 and 93%. Positive and negative predictive values were 93 and 87%, respectively. In the sub-group of subjects with a change in the primary diagnosis following pUS there was no false-negative or false-positive findings.Screening by pUS assessed vascular and cardiac anatomy and function accurately and enabled correction of the diagnosis in 16% of patients admitted to a cardiac unit. In 55% of the participants, the cardiovascular ultrasound screening had important diagnostic influence. We suggest that it would be appropriate to implement strategies and systems for routinely adding an ultrasound cardiovascular examination to patients in cardiac units.CONCLUSIONScreening by pUS assessed vascular and cardiac anatomy and function accurately and enabled correction of the diagnosis in 16% of patients admitted to a cardiac unit. In 55% of the participants, the cardiovascular ultrasound screening had important diagnostic influence. We suggest that it would be appropriate to implement strategies and systems for routinely adding an ultrasound cardiovascular examination to patients in cardiac units.
We aimed to study the diagnostic influence of adding a routine cardiovascular ultrasound screening of the cardiac anatomy and function, the pericardium, the pleura and the abdominal great vessels by the new pocket-size ultrasound device (pUS) with grey scale and colour Doppler imaging. In 119 randomly selected patients admitted to a cardiac unit at a non-university hospital, routinely adding a cardiovascular ultrasonography of only 4.4 min with a pocket-size device corrected the primary diagnosis in 16% of patients. In addition, 29% had the primary diagnosis verified and in 10% an additional important diagnosis was made. Higher age predicted any diagnostic influence of pUS screening with an increase of 61% (P=0.003) per 10 years of higher age. Overall, the pUS screening had a sensitivity and specificity with respect to detecting at least moderate pathology of 97 and 93%. Positive and negative predictive values were 93 and 87%, respectively. In the sub-group of subjects with a change in the primary diagnosis following pUS there was no false-negative or false-positive findings. Screening by pUS assessed vascular and cardiac anatomy and function accurately and enabled correction of the diagnosis in 16% of patients admitted to a cardiac unit. In 55% of the participants, the cardiovascular ultrasound screening had important diagnostic influence. We suggest that it would be appropriate to implement strategies and systems for routinely adding an ultrasound cardiovascular examination to patients in cardiac units.
Author Haugen, Bjørn Olav
Kleinau, Jens Olaf
Dalen, Håvard
Skjetne, Kyrre
Graven, Torbjørn
Salvesen, Øyvind
AuthorAffiliation 1 Levanger Hospital, Nord-Trøndelag Health Trust , Levanger 7600 , Norway
2 MI Laboratory, Department of Circulation and Medical Imaging , Norwegian University of Science and Technology , Norway
3 Department of Cardiology , St Olavs Hospital/Trondheim University Hospital , Trondheim , Norway
4 Department of Cancer Research and Molecular Medicine , Norwegian University of Science and Technology , Norway
AuthorAffiliation_xml – name: 3 Department of Cardiology , St Olavs Hospital/Trondheim University Hospital , Trondheim , Norway
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References 9118558 - Circulation. 1997 Mar 18;95(6):1686-744
19270053 - Eur J Echocardiogr. 2009 Mar;10(2):165-93
16096453 - Crit Care Med. 2005 Aug;33(8):1757-63
17631091 - Am J Cardiol. 2007 Jul 15;100(2):321-5
15684208 - Ann Intern Med. 2005 Feb 1;142(3):198-202
21345104 - N Engl J Med. 2011 Feb 24;364(8):749-57
16458610 - Eur J Echocardiogr. 2006 Mar;7(2):79-108
20817693 - Eur J Echocardiogr. 2011 Jan;12(1):3-10
20394904 - JACC Cardiovasc Imaging. 2010 Apr;3(4):421-8
10675158 - Lancet. 2000 Jan 8;355(9198):80-1
15522567 - Eur J Intern Med. 2004 Oct;15(6):337-347
19114170 - Am J Med. 2009 Jan;122(1):35-41
17617312 - J Am Soc Echocardiogr. 2007 Jul;20(7):857-61
20541719 - JACC Cardiovasc Imaging. 2010 Jun;3(6):641-9
20435783 - Eur J Echocardiogr. 2010 May;11(4):307-32
15894238 - Eur J Echocardiogr. 2005 Jun;6(3):196-201
11419879 - J Am Coll Cardiol. 2001 Jun 15;37(8):2013-8
21110840 - Cardiovasc Ultrasound. 2010;8:51
14675855 - Eur J Heart Fail. 2003 Dec;5(6):767-74
19252189 - Eur J Echocardiogr. 2009 Jun;10(4):537-42
19065003 - Eur J Echocardiogr. 2009 Jan;10(1):1-25
21216764 - Eur J Echocardiogr. 2011 Feb;12(2):85-7
20375260 - Eur J Echocardiogr. 2010 Apr;11(3):223-44
18579482 - Eur J Echocardiogr. 2008 Jul;9(4):438-48
17467518 - Lancet. 2007 Apr 28;369(9571):1471-80
21074362 - J Am Soc Echocardiogr. 2011 Feb;24(2):117-24
11922641 - Eur Heart J. 2002 Apr;23(7):523-7
21126857 - J Am Soc Echocardiogr. 2011 Feb;24(2):111-6
References_xml – reference: 10675158 - Lancet. 2000 Jan 8;355(9198):80-1
– reference: 19065003 - Eur J Echocardiogr. 2009 Jan;10(1):1-25
– reference: 18579482 - Eur J Echocardiogr. 2008 Jul;9(4):438-48
– reference: 19114170 - Am J Med. 2009 Jan;122(1):35-41
– reference: 20817693 - Eur J Echocardiogr. 2011 Jan;12(1):3-10
– reference: 17467518 - Lancet. 2007 Apr 28;369(9571):1471-80
– reference: 21216764 - Eur J Echocardiogr. 2011 Feb;12(2):85-7
– reference: 17631091 - Am J Cardiol. 2007 Jul 15;100(2):321-5
– reference: 20541719 - JACC Cardiovasc Imaging. 2010 Jun;3(6):641-9
– reference: 15522567 - Eur J Intern Med. 2004 Oct;15(6):337-347
– reference: 21074362 - J Am Soc Echocardiogr. 2011 Feb;24(2):117-24
– reference: 15894238 - Eur J Echocardiogr. 2005 Jun;6(3):196-201
– reference: 19252189 - Eur J Echocardiogr. 2009 Jun;10(4):537-42
– reference: 21126857 - J Am Soc Echocardiogr. 2011 Feb;24(2):111-6
– reference: 14675855 - Eur J Heart Fail. 2003 Dec;5(6):767-74
– reference: 9118558 - Circulation. 1997 Mar 18;95(6):1686-744
– reference: 16096453 - Crit Care Med. 2005 Aug;33(8):1757-63
– reference: 19270053 - Eur J Echocardiogr. 2009 Mar;10(2):165-93
– reference: 15684208 - Ann Intern Med. 2005 Feb 1;142(3):198-202
– reference: 21110840 - Cardiovasc Ultrasound. 2010;8:51
– reference: 21345104 - N Engl J Med. 2011 Feb 24;364(8):749-57
– reference: 16458610 - Eur J Echocardiogr. 2006 Mar;7(2):79-108
– reference: 11922641 - Eur Heart J. 2002 Apr;23(7):523-7
– reference: 11419879 - J Am Coll Cardiol. 2001 Jun 15;37(8):2013-8
– reference: 20375260 - Eur J Echocardiogr. 2010 Apr;11(3):223-44
– reference: 20435783 - Eur J Echocardiogr. 2010 May;11(4):307-32
– reference: 20394904 - JACC Cardiovasc Imaging. 2010 Apr;3(4):421-8
– reference: 17617312 - J Am Soc Echocardiogr. 2007 Jul;20(7):857-61
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SubjectTerms Adult
Aged
Aged, 80 and over
Cardiovascular Diseases - diagnostic imaging
Cardiovascular System - diagnostic imaging
Clinical/Original Papers
Coronary Care Units
Echocardiography - instrumentation
Female
Humans
Male
Mass Screening
Middle Aged
Pleura - diagnostic imaging
Reproducibility of Results
Title Diagnostic influence of cardiovascular screening by pocket-size ultrasound in a cardiac unit
URI https://www.ncbi.nlm.nih.gov/pubmed/21821611
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https://pubmed.ncbi.nlm.nih.gov/PMC3192508
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