Objective The purpose of this study was to compare if non-physician, inexperienced ultrasound subjects can take quality diagnostic images after watching a brief educational video and using reference cue cards (autonomous group) versus taking ultrasound images with expert guidance using a satellite connection. Methods Six non-medical, inexperienced ultrasound subjects from a rural area (Arctic Circle) obtained ultrasound images of target anatomic regions using a portable ultrasound device after receiving expert-guided training or autonomous training (educational video and cue cards). Real-time expert guidance was provided using an audiovisual tele-ultrasound connection with direct ultrasound video compression which was relayed to a remote expert via a secure satellite connection. The resultant images from all studies were blindly reviewed by imaging experts for determination of diagnostic adequacy. Results All of the examinations were completed in \15 min. The blinded expert identified 85.1% of autonomously acquired images and 86.2% of the images obtained by expert guidance to be of diagnostic quality; there was no statistical difference between the two groups (P = 0.6653). Conclusion Non-physician, inexperienced subjects can quickly educate themselves to retrieve diagnostic quality ultrasound images whether they are being expert-guided or trained autonomously.
A correlative trend was found between the degree of LV sphericity and the amount of gravitational force directed caudal to the longitudinal orientation of the body. The importance of this finding is uncertain, but may have implications regarding physiologic adaptations in the myocardial structure secondary to changes in LV wall stress upon prolonged exposure to microgravity.
Purpose Remote guidance techniques have been developed by NASA researchers to allow non-clinicians to perform complex ultrasound examinations on the International Space Station to increase clinical diagnostic capabilities. Real-time or near real-time communication will not be an option for missions beyond the Earth and Moon; non-experts will have to scan autonomously. We investigated the ability of non-experts to perform point-of-care ultrasound in a remote location using ''virtual guidance'', consisting of a video-based training and troubleshooting guide to acquire cardiac ultrasound images. Methods Non-expert operators (n = 4) reviewed a short (\15 min) cardiac ultrasound examination training video using dedicated video glasses and an iPod. They then acquired echocardiography scansets on normal, volunteer subjects at Resolute Bay, Canada using a portable ultrasound device. Image quality was evaluated using a scoring system by two experts in echocardiography. ResultsCardiac ultrasound examinations were autonomously completed by four non-expert operators using virtual guidance in under 30 min and judged to be adequate for clinical interpretation. Virtual guidance with the video glasses and streaming examination guide was accepted by all operators as an effective guidance technique for this purpose. Conclusions Virtual guidance is a novel technique that may allow data acquisition by non-expert operators autonomously when on-site expertise or real time support is not available. Further refinement of the technique should be explored to enhance autonomous medical capabilities in isolated or underserved settings, either on or off the planet.
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