Cardiac assessment accuracy by students using palm-held ultrasound compared to physical examination by skilled cardiologists: a pilot study with a single medical student
Abstract Background Despite the inherent limitations of the traditional cardiac physical examination (PE), it has not yet been replaced by a more accurate method. Methods We hypothesized that a single medical student, following a brief training (two academic hours) with the PHU, will better identify...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | Cardiovascular Ultrasound |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12947-022-00277-2 |
| _version_ | 1818776657246289920 |
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| author | Shirley Sarig Tsafrir Or Gassan Moady Shaul Atar |
| author_facet | Shirley Sarig Tsafrir Or Gassan Moady Shaul Atar |
| author_sort | Shirley Sarig |
| collection | DOAJ |
| description | Abstract Background Despite the inherent limitations of the traditional cardiac physical examination (PE), it has not yet been replaced by a more accurate method. Methods We hypothesized that a single medical student, following a brief training (two academic hours) with the PHU, will better identify abnormal findings including significant valvular diseases, pericardial effusion and reduced LV function, as compared to PE performed by senior cardiologists and cardiology fellows. Transthoracic echocardiogram (TTE) served as a ‘gold standard’. Results Seventy-seven patients underwent TTE, of them 64 had an abnormal finding. PE identified 34 patients with an abnormal finding compared to 52 identified by PHU (p < 0.05). Ejection fraction (EF) below 50% was found in 35 patients on TTE, compared to only 15 and 6 patients by PE and PHU, respectively (p < 0.05). There was no difference in valvular dysfunction diagnosis detected by PE and medical students using PHU. The overall accuracy of PHU compared to TTE was 87%, with a specificity of 94% and sensitivity of 64% (the low sensitivity was driven mainly by EF assessment), whereas the accuracy of PE was 91%, specificity 91% and sensitivity 38% (again driven by poor EF assessment). Conclusions Cardiac evaluation using PHU by a single medical student was able to demonstrate similar accuracy as PE done by cardiac specialists or cardiology fellows. The study topic should be validated in future studies with more medical students with a very brief training of cardiac ultrasound. |
| first_indexed | 2024-12-18T11:16:25Z |
| format | Article |
| id | doaj.art-683c0d1103b74f7697fdac6acd2e64a6 |
| institution | Directory Open Access Journal |
| issn | 1476-7120 |
| language | English |
| last_indexed | 2024-12-18T11:16:25Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Ultrasound |
| spelling | doaj.art-683c0d1103b74f7697fdac6acd2e64a62022-12-21T21:09:55ZengBMCCardiovascular Ultrasound1476-71202022-03-012011610.1186/s12947-022-00277-2Cardiac assessment accuracy by students using palm-held ultrasound compared to physical examination by skilled cardiologists: a pilot study with a single medical studentShirley Sarig0Tsafrir Or1Gassan Moady2Shaul Atar3Azrieli Faculty of Medicine in the Galilee, Bar-Ilan UniversityAzrieli Faculty of Medicine in the Galilee, Bar-Ilan UniversityAzrieli Faculty of Medicine in the Galilee, Bar-Ilan UniversityAzrieli Faculty of Medicine in the Galilee, Bar-Ilan UniversityAbstract Background Despite the inherent limitations of the traditional cardiac physical examination (PE), it has not yet been replaced by a more accurate method. Methods We hypothesized that a single medical student, following a brief training (two academic hours) with the PHU, will better identify abnormal findings including significant valvular diseases, pericardial effusion and reduced LV function, as compared to PE performed by senior cardiologists and cardiology fellows. Transthoracic echocardiogram (TTE) served as a ‘gold standard’. Results Seventy-seven patients underwent TTE, of them 64 had an abnormal finding. PE identified 34 patients with an abnormal finding compared to 52 identified by PHU (p < 0.05). Ejection fraction (EF) below 50% was found in 35 patients on TTE, compared to only 15 and 6 patients by PE and PHU, respectively (p < 0.05). There was no difference in valvular dysfunction diagnosis detected by PE and medical students using PHU. The overall accuracy of PHU compared to TTE was 87%, with a specificity of 94% and sensitivity of 64% (the low sensitivity was driven mainly by EF assessment), whereas the accuracy of PE was 91%, specificity 91% and sensitivity 38% (again driven by poor EF assessment). Conclusions Cardiac evaluation using PHU by a single medical student was able to demonstrate similar accuracy as PE done by cardiac specialists or cardiology fellows. The study topic should be validated in future studies with more medical students with a very brief training of cardiac ultrasound.https://doi.org/10.1186/s12947-022-00277-2Palm-held ultrasoundTransthoracic echocardiographyPhysical examination |
| spellingShingle | Shirley Sarig Tsafrir Or Gassan Moady Shaul Atar Cardiac assessment accuracy by students using palm-held ultrasound compared to physical examination by skilled cardiologists: a pilot study with a single medical student Cardiovascular Ultrasound Palm-held ultrasound Transthoracic echocardiography Physical examination |
| title | Cardiac assessment accuracy by students using palm-held ultrasound compared to physical examination by skilled cardiologists: a pilot study with a single medical student |
| title_full | Cardiac assessment accuracy by students using palm-held ultrasound compared to physical examination by skilled cardiologists: a pilot study with a single medical student |
| title_fullStr | Cardiac assessment accuracy by students using palm-held ultrasound compared to physical examination by skilled cardiologists: a pilot study with a single medical student |
| title_full_unstemmed | Cardiac assessment accuracy by students using palm-held ultrasound compared to physical examination by skilled cardiologists: a pilot study with a single medical student |
| title_short | Cardiac assessment accuracy by students using palm-held ultrasound compared to physical examination by skilled cardiologists: a pilot study with a single medical student |
| title_sort | cardiac assessment accuracy by students using palm held ultrasound compared to physical examination by skilled cardiologists a pilot study with a single medical student |
| topic | Palm-held ultrasound Transthoracic echocardiography Physical examination |
| url | https://doi.org/10.1186/s12947-022-00277-2 |
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