Diagnostic Accuracy and Cost‐Effectiveness of a Pocket‐Sized Transthoracic Echocardiographic Imaging Device

Kitada, Ryoko; Fukuda, Shota; Watanabe, Hiroyuki; Oe, Hiroki; Abe, Yukio; Yoshiyama, Minoru; Song, Jong Min; Sitges, Marta; Shiota, Takahiro; Ito, Hiroshi; Yoshikawa, Junichi

doi:10.1002/clc.22171

Cited by 50 publications

(59 citation statements)

References 32 publications

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“…Previous studies reported that the use of pocket-size ultrasound devices was associated with a 20–30% cost reduction in healthcare costs9 15–20 Nevertheless, most reported studies were conducted by experts. It has been suggested that internist may be able to use these hand-held devices after a limited training period 21–24.…”

Section: Discussionmentioning

confidence: 99%

Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation

Evangelista

Galuppo

Méndez³

et al. 2016

Heart

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Section: Discussionmentioning

confidence: 99%

Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation

Evangelista

Galuppo

Méndez³

et al. 2016

Heart

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“…Subsequently, the cost-effectiveness of the pocket-echo for screening various cardiac diseases has been reported. 21 Dijos et al showed an excellent correlation between the abdominal aortic diameter determined by standard echocardiography and the pocket-echo, resulting in 100% agreement for the AAA diagnosis. 22 Considering the portability and low cost of pocket-sized imaging devices, similar to stethoscopes, the pocket-echo may alter the current screening strategies for AAA by providing a supplement to physical examination.…”

Section: Prevalence and Determinants Of Aaamentioning

confidence: 96%

Multicenter Investigations of the Prevalence of Abdominal Aortic Aneurysm in Elderly Japanese Patients With Hypertension

Fukuda

Watanabe

Iwakura

et al. 2015

Circ J

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, MD for the AAA Japan Study Investigators Background: Physical examination as an initial screening tool to diagnose abdominal aortic aneurysm (AAA) has lost favor over the past 20 years. This multicenter cohort study aimed to determine the prevalence of AAA in elderly Japanese patients with hypertension (HT) and to clarify the diagnostic accuracy of physical examination using a pocket-sized ultrasound imaging device (the "pocket-echo"). Methods and Results:A total of 1,731 patients with HT aged >60 years from 20 collaborating institutions were enrolled in this study. Abdominal palpation was performed on physical examination, and the pocket-echo was used to confirm the diagnosis of AAA. The abdominal aorta was well visualized in 1,692 patients (98%). AAA was discovered in 69 patients (4.1%), with advanced age and male sex identified as independent risk factors. The prevalence of AAA increased according to age regardless of sex, and reached 9.2% and 5.7%, respectively, in males and females ≥80 years. Overall, 33 cases of AAA were missed on abdominal palpation (sensitivity, 52%), whereas for AAAs >40 mm, the sensitivity was 75%. Conclusions:We assessed the utility of the pocket-echo and physical examination for diagnosing AAA in Japanese patients with HT aged over 60 years. Our findings highlight the importance of AAA screening programs in high-risk Japanese populations, and confirm the ability of physical examination to detect large, but not small, AAAs. (Circ J 2015; 79: 524 -529)

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“…In everyday clinical practice pocket-size devices could complement the physical examination in outreach clinics and in intensive care units; they may serve as a tool for fast initial cardiac assessment in emergency units, during cardiologic counseling, in ambulances and for screening programs in schools and industries [7]. Moreover, miniaturized echo systems allow improvement of the cost-effectiveness of the service provided by the echo-lab for inpatients and avoid patients' discomfort derived from prolonged waiting time [20,21]. The main limitation of these devices is represented by poor image quality linked to the type of machine used and to the operator experience.…”

Section: Discussionmentioning

confidence: 99%

Hand-held echocardiography in the setting of pre-operative cardiac evaluation of patients undergoing non-cardiac surgery: results from a randomized pilot study

Cavallari

Mega

Goffredo

et al. 2015

Int J Cardiovasc Imaging

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Transthoracic echocardiography is not a routine test in the pre-operative cardiac evaluation of patients undergoing non-cardiac surgery but may be considered in those with known heart failure and valvular heart disease or complaining cardiac symptoms. In this setting, hand-held echocardiography (HHE) could find a potential application as an alternative to standard echocardiography in selected patients; however, its utility in this context has not been investigated. The aim of this pilot study was to evaluate the conclusiveness of HHE compared to standard echocardiography in this subset of patients. 100 patients scheduled for non-cardiac surgery were randomized to receive a standard exam with a Philips Ie33 or a bedside evaluation with a pocket-size imaging device (Opti-Go, Philips Medical System). The primary endpoint was the percentage of satisfactory diagnosis at the end of the examination referred as conclusiveness. Secondary endpoints were the mean duration time and the mean waiting time to perform the exams. No significant difference in terms of conclusiveness between HHE and standard echo was found (86 vs 96%; P = 0.08). Mean duration time of the examinations was 6.1 ± 1.2 min with HHE and 13.1 ± 2.6 min with standard echocardiography (P < 0.001). HHE resulted in a consistent save of waiting time because it was performed the same day of clinical evaluation whereas patients waited 10.1 ± 6.1 days for a standard echocardiography (P < 0.001). This study suggests the potential role of HHE for pre-operative evaluation of selected patients undergoing non-cardiac surgery, since it provided similar information but it was faster and earlier performed compared to standard echocardiography.

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Diagnostic Accuracy and Cost‐Effectiveness of a Pocket‐Sized Transthoracic Echocardiographic Imaging Device

Cited by 50 publications

References 32 publications

Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation

Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation

Multicenter Investigations of the Prevalence of Abdominal Aortic Aneurysm in Elderly Japanese Patients With Hypertension

Hand-held echocardiography in the setting of pre-operative cardiac evaluation of patients undergoing non-cardiac surgery: results from a randomized pilot study

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