Point-of-Care Ultrasound: Applications in Low- and Middle-Income Countries

Tran, Timothy T.; Hlaing, Maung; Krause, Martín

doi:10.1007/s40140-020-00429-y

Cited by 24 publications

(24 citation statements)

References 68 publications

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“…The advent of affordable, portable ultrasound devices has led to the increasing use of POCUS for the diagnosis of a range of infectious diseases [17]. For adult pneumonia, meta-analyses suggest that LUS has similar or higher sensitivity and specificity to CXR [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

“…By contrast, point-of-care ultrasound (POCUS) devices are inexpensive, easily portable to rural centres, do not result in exposure to ionising radiation and do not require radiological staff [9,10], making their use attractive for practical reasons in low-resource settings. The term POCUS has been used in different ways in the literature but is generally defined as an ultrasound exam performed and interpreted in real-time by a single nonradiologist operator [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…POCUS devices have been used for the diagnosis of several infectious diseases in low-and middle-income settings [17], notably with the focused assessment with sonography for human immunodeficiency virus (HIV)-associated extrapulmonary TB (FASH) protocol [18,19]. Lung ultrasound (LUS) has also been used successfully in the diagnosis of adult pneumonia, with meta-analyses suggesting it has similar or higher sensitivity and specificity to CXR [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review

et al. 2021

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The advent of affordable, portable ultrasound devices has led to increasing interest in the use of point-of-care ultrasound (POCUS) for the detection of pulmonary TB (PTB). We undertook a systematic review of the diagnostic accuracy of POCUS for PTB. Five databases were searched for articles published between January 2010 and June 2020. Risk of bias was assessed using QUADAS-2. Data on sensitivity and specificity of individual lung ultrasound findings were collected, with variable reference standards including PCR and sputum smear microscopy. Six of 3,919 reviewed articles were included: five in adults and one in children, with a total sample size of 564. Studies had high risk of bias in many domains. In adults, subpleural nodule and lung consolidation were the lung ultrasound findings with the highest sensitivities, ranging from 72.5% to 100.0% and 46.7% to 80.4%, respectively. Only one study reported specificity data. Variability in sensitivity may be due to variable reference standards or may imply operator dependence. There is insufficient evidence to judge the diagnostic accuracy of POCUS for PTB. There is also no consensus on the optimal protocols for acquiring and analysing POCUS images for PTB. New studies which minimise potential sources of bias are required to further assess the diagnostic accuracy of POCUS for PTB.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review

et al. 2021

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“…Tran et al reviewed POCUS applications in low- and middle-income countries. They found it particularly beneficial in high need, low resource areas allowing physicians to diagnose many pathologies and initiate care quickly [ 10 ]. Rural areas face many obstacles in access to care, including patient presentation delays, urgency underestimation, and lack of subspeciality and essential support services.…”

Section: Discussionmentioning

confidence: 99%

“…With current high-end portable devices having a price point of around $2000, their usage has spread throughout hospitals, allowing operators to interpret images during patient visits [ 10 ]. There are many different POCUS systems; some have a single, one-time fee for the acquisition of the hardware which can export images to any PACS system; others have a lower cost for the hardware and subsequently a yearly fee for image processing and storage.…”

Section: Discussionmentioning

confidence: 99%

Point-of-Care Ultrasound Reduces Visit Time and Cost of Care for Infants with Developmental Dysplasia of the Hip

Herrero

Colon

Nagapurkar

et al. 2021

JOIO

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Background Healthcare institutions and policymakers are searching for system-wide approaches to reduce costs while maintaining quality and improving patient outcomes. In most healthcare systems infants referred for the detecting or treating developmental dysplasia of the hip (DDH) are sent to a radiology department for sonographic evaluation. The total duration of visit and cost of visit are essential variables in any healthcare setting and affect both efficiency and “the bottom line”. By having the treating clinician perform point-of-care ultrasound (POCUS) for the detection and follow-up of patients with DDH, we hypothesize that there would be a significant reduction in the time spent on the visit and the cost incurred without compromising quality or patient satisfaction. To our knowledge, no prior study has examined the effect of incorporating POCUS on the duration and cost of the visit in patients with DDH. Purpose To determine if there was a difference in the duration of the visit for patients with DDH when POCUS was performed compared to when traditional “formal” sonography was performed. To determine if there was a difference in the cost of the visit for patients with DDH when POCUS was performed compared to when traditional “formal” sonography was performed. Methods Data for visits to a specialized outpatient office were collected over two years at a single-specialty orthopedic hospital, comparing the duration and cost of the visit between patient encounters for infants who had “formal” sonograms performed in the radiology suite to infants who underwent POCUS of the hip. In all, we included 532 patient encounters, 326 patients had POCUS performed, and 206 had a “formal” ultrasonographic evaluation performed. Of these, 140 were new evaluations and 392 were follow-up evaluations for treatment. Of the 140 new patients, 80 were in the POCUS group, and 60 were in the “formal” US group. Of the 392 follow-ups, 246 were in the POCUS group, and 146 were in the “formal” US group. Results The mean duration of the encounter for the POCUS group was 42 min (range 16–75 min), and for the “formal” US group, it was 92 min (range 36–163 min). This difference was statistically significant ( p = 0.002). The mean cost of the encounter for the POCUS group was $121.13, and for the “formal” US group, it was $339.38. This difference was statistically significant ( p = 0.002). Conclusion Ultimately, our study demonstrated a statistically significant reduction in the duration and cost of a patient encounter for infants with DDH when they undergo POCUS rather than “formal” sonographic evaluation.

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Current use and perceived barriers of emergency point-of-care ultrasound by African health care practitioners

Hoving

Alenyo

Komagum

et al. 2022

African Journal of Emergency Medicine

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Point-of-Care Ultrasound: Applications in Low- and Middle-Income Countries

Cited by 24 publications

References 68 publications

Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review

Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review

Point-of-Care Ultrasound Reduces Visit Time and Cost of Care for Infants with Developmental Dysplasia of the Hip

Current use and perceived barriers of emergency point-of-care ultrasound by African health care practitioners

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