ArticleBMC medical education2019
Hand-held cardiac ultrasound examinations performed in primary care patients by nonexperts to identify reduced ejection fraction.
Article in BMC medical education, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02939157 (Pocket-sized Ultrasound for Point-of-care Diagnosis of Heart Failure), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pocket-sized Ultrasound for Point-of-care Diagnosis of Heart Failure
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic accuracy of handheld cardiac ultrasound device for assessment of left ventricular structure and function: systematic review and meta-analysis.Heart (British Cardiac Society) · 2021Pooled it
- Point-of-care ultrasound improves the diagnosis of heart failure in patients with dyspnea in primary care.Frontiers in medicine · 2026Article
- Artificial intelligence-assisted evaluation of cardiac function by oncology staff in chemotherapy patients.European heart journal. Digital health · 2024Article
- Usefulness of Heart Failure Categories Based on Left Ventricular Ejection Fraction.Journal of the American Heart Association · 2024Article
- Artificial Intelligence-Based Left Ventricular Ejection Fraction by Medical Students for Mortality and Readmission Prediction.Diagnostics (Basel, Switzerland) · 2024Article
- Combination of Tele-Cardiology Tools for Cardiovascular Risk Stratification in Primary Care: Data from the PROVAR+ Study.Arquivos brasileiros de cardiologia · 2024Article
- The measurement of the left ventricle ejection fraction by a bedside FoCUS examination.Internal and emergency medicine · 2023Article
- Reasons for disagreement between screening and standard echocardiography in primary care: data from the PROVAR + study : Disagreement between screening and standard echo.The international journal of cardiovascular imaging · 2023Article
- Cardiovascular examination using hand-held cardiac ultrasound.Journal of echocardiography · 2022Review
- Learning strategies of general practitioners striving to achieve point-of-care ultrasound competence: a qualitative study.Scandinavian journal of primary health care · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundEarly identification of patients with reduced left ventricular ejection fraction (LVEF) could facilitate the care of patients with suspected heart failure (HF). We examined if (1) focused cardiac ultrasound (FCU) performed with a hand-held device (Vscan 1.2) could identify patients with LVEF < 50%, and (2) the distribution of HF types among patients with suspected HF seen at primary care clinics.
methodsFCU performed by general practitioners (GPs)/GP registrars after a training programme comprising 20 supervised FCU examinations were compared with the corresponding results from conventional cardiac ultrasound by specialists. The agreement between groups of estimated LVEF < 50%, after visual assessment of global left ventricular function, was compared. Types of HF were determined according to the outcomes from the reference examinations and serum levels of natriuretic peptides (NT-proBNP).
resultsOne hundred patients were examined by FCU that was performed by 1-4 independent examiners as well as by the reference method, contributing to 140 examinations (false positive rate, 19.0%; false negative rate, 52.6%; sensitivity, 47.4% [95% confidence interval [CI]: 27.3-68.3]; specificity, 81.0% [95% CI: 73.1-87.0]; Cohen's κ measure for agreement = 0.22 [95% CI: 0.03-0.40]). Among patients with false negative examinations, 1/7 had HF with LVEF < 40%, while the others had HF with LVEF 40-49% or did not meet the full criteria for HF. In patients with NT-proBNP > 125 ng/L and fulfilling the criteria for HF (68/94), HF with preserved LVEF (≥50%) predominated, followed by mid-range (40-49%) or reduced LVEF (< 40%) HF types (53.2, 11.7 and 7.4%, respectively).
conclusionsThere was poor agreement between expert examiners using standard ultrasound equipment and non-experts using a handheld ultrasound device to identify patients with reduced LVEF. Asides from possible shortcomings of the training programme, the poor performance of non-experts could be explained by their limited experience in identifying left ventricular dysfunction because of the low percentage of patients with HF and reduced ejection fraction seen in the primary care setting.
trial registrationThe study was registered at ClinicalTrials.gov (NCT02939157). Registered 19 October 2016.
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