Point-of-Care Ultrasonography

Abstract

cal journal was established in 1984. 8 Nearly 40 years later, it is regrettable that journal editors and leaders in academic medicine are still debating whether authors of commentaries should have any financial interest in a company (or its competitor) whose product was discussed in an article they are commenting on. The answer is no.

Point-of-Care Ultrasonography: Clearly More Than a Pretty Picture

“…2 Because we found insufficient evidence for POCUS as a replacement test, the ACP guideline makes no recommendation for this situation. 2 Our recommendation was based on similar advantages of POCUS as pointed out in the editorial 1 and consistent with evaluations and use of many diagnostic tests-POCUS improves test accuracy when used in addition to standard diagnostic testing. Importantly, POCUS increased the proportion of correct diagnoses when used in addition to the standard diagnostic pathway.…”

“…We did not intend to imply that the American College of Physicians' position statement 3 endorses widespread or replacement use by POCUS; rather, we cited the guideline to underscore the general growing acceptance of POCUS. 1 We welcome Dr Wilt and colleagues' clarification of the stipulations set forth by the guideline's conditional recommendation and acknowledgment of the limited evidence regarding the use of POCUS.…”

Hierarchy of evidence for endometriosis diagnosis and surgery.

“…Medical therapy needs re-appraisal and for extensive surgery, the judgement of surgeons with experience needs validation. The complexity will need better integration of statistical analysis and inference to understand which exams and therapies improve outcomes (82).…”

Point-of-Care Ultrasonography: Clearly More Than a Pretty Picture

“…2 While a negative randomized clinical trial (RCT) was noted by the authors, 1 several trials demonstrating positive outcomes were not, including a trial of 2759 patients with suspected nephrolithiasis in which POCUS was compared with radiologic studies-not as a rule-out test, but as part of a diagnostic strategy. 4 Choices in evidence selection notwithstanding, the authors called for evidence of outcome benefits, 1 as clinicians often do when tasked with any new intervention or diagnostic strategies. Pursuit of mortality reduction as an outcome of interest is appealing but overly simplistic.…”

“…1 raises concerns around the limitations of emerging evidence on point-of-care ultrasonography (POCUS), similar to the concerns we noted in the American College of Physicians' (ACP) clinical guideline. 2 However, we would like to clarify several key items mentioned in the editorial 1 that do not represent the ACP guideline correctly.…”