ArticleThe Australian journal of rural health2026
An Evaluation of the Accuracy of Point of Care Ultrasound by Family Physicians in Rural British Columbia, Canada: Methodological Insights.
Article in The Australian journal of rural health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study investigated the diagnostic accuracy of point of care ultrasound (PoCUS) by rural family physicians (FPs), using consensus 'imaging expert' interpretation as the reference standard.
designCross-sectional.
settingBritish Columbia, Canada.
participantsFive rural FPs and seven specialist physicians (imaging experts).
methodsRural FPs saved images from their PoCUS scans over 2-10 weeks. For each scan, two expert reviewers, who were unaware of the identity of FP study participants and their interpretation of scans, independently interpreted images.
main outcome measuresImage interpretation agreement between FPs and imaging experts: percentage agreement, sensitivity, and specificity. Inter-rater reliability between expert reviewers when interpreting images, as measured by percentage agreement.
resultsSeven imaging experts reviewed images from 55 scans performed by five rural FPs. Among the 20 scans with expert pair agreement (that was not 'unable to assess'), expert interpretation was the same as an FP's for all but one scan (95%). For the other 35 scans, experts in a pair (a) both could not make an assessment based on images provided ('unable to assess') (n = 4) or (b) had differing interpretations (n = 31).
conclusionWe found interpretation agreement among imaging experts for a minority of scans, resulting in inadequate power to assess the diagnostic accuracy of PoCUS by rural FPs. When using secondary image review to assess rural PoCUS quality, we recommend limiting the number of PoCUS working diagnoses being investigated, developing image sharing guidelines for FP participants, and using consensus agreement by multiple experts as the reference standard.
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