Value of a Cardiovascular Limited Ultrasound Examination Using a Hand-Carried Ultrasound Device on Clinical Management in an Outpatient Medical Clinic

Kimura, Bruce J.; Shaw, David; Agan, Donna L.; Amundson, Stan A.; Ping, Andrew C.; DeMaria, Anthony N.

doi:10.1016/j.amjcard.2007.02.104

Cited by 56 publications

(48 citation statements)

References 28 publications

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“…We derived CLUE to quickly screen for important targets that had evidence-basis to affect outcome, such as manifestations of subclinical atherosclerosis or chamber enlargement due to elevated filling pressures. Subsequent CLUE outcome studies have demonstrated diagnostic accuracy and prognostic value in its components, 18,26,29,30 and an effect upon medical decisionmaking, 21 even when performed by briefly trained novices. 18,21,30 It is anticipated that this cardiovascular examination will later expand to a more advanced version or become a component of a full-body ''ultrasoundassisted physical.''…”

Section: Discussionmentioning

confidence: 99%

“…9. Abdominal aortic aneurysm Focal dilation $1.5 Â the size of neighboring segment 21 Reduced SN due to bowel gas or mistaking a normal IVC for the aorta. FPs of cysts identified as aneurysmal disease…”

Section: Lung Comet-tail Artifactmentioning

confidence: 99%

“…During clinical care rotations over the 3-year residency, all residents imaged a minimum of 30 patients (at least 10 proctored studies during Reduced SN for acute or apical wall motion abnormalities; FPs due to severe aortic regurgitation, mitral stenosis 3. Left atrial enlargement LA appears larger than aortic root (AP diameter) throughout the cardiac cycle 21,[24][25][26] Reduced SN when LA asymmetrically enlarges (elongates); FPs due to far field artifact mistaken for posterior LA wall.…”

Section: Program Overviewmentioning

confidence: 99%

“…Evidence-basis for the exam targets and specifics of subjective diagnostic CLUE criteria (Table 1) have been published elsewhere. [21][22][23][24][25][26][27][28][29][30] Two useful mnemonics were created to teach the imaging protocol. If using only the 3 MHz cardiac probe, residents were taught to ''work backward'' against the flow of blood, in regards to physiologic effects and the sequence of CLUE views.…”

Section: Program Overviewmentioning

confidence: 99%

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Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Kimura

Amundson

Phan

et al. 2012

Journal of Hospital Medicine

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BACKGROUND: Despite the future potential of using ultrasound stethoscopes to augment the bedside cardiac physical, few data exist on a general cardiovascular imaging protocol that can be taught to physicians on a perpetual basis as a curriculum in graduate medical education. METHODS: During the past decade, we developed and integrated a cardiovascular limited ultrasound training program within the confines of an internal medicine residency. The evidence‐based rationale for the exam, the teaching methods, and curriculum are delineated, and subsequent observations regarding program requirements, proficiency, and academic outcomes are explored. Analysis of variance and linear regression assessed for relationships between academic scores, chief resident selection, and gender to proficiency in ultrasound. RESULTS: A brief, 5‐minute cardiovascular limited ultrasound exam (CLUE) was taught using both didactic and bedside methods, and practiced primarily within the cardiology consult, outpatient clinic, and intensive care rotations. Program costs were minimized by employing readily available institutional resources. After a 2‐year lead‐in training phase, the subsequent 4 years of senior resident performance (n = 41 residents) showed an 81% pass rate in CLUE competency. Resident ultrasound performance did not relate to academic scores (r = 0.05, P = 0.75), chief resident selection, nor gender. Observations regarding resident pitfalls in CLUE practice and increased participation in extracurricular research are described. CONCLUSIONS: We report our initial experience in developing and implementing a training program for bedside cardiovascular ultrasound examination that employed evidence‐based techniques, set proficiency goals, and assessed resident performance. It may be feasible to teach future internist–hospitalists the technique of bedside ultrasound during residency. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine

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Section: Discussionmentioning

confidence: 99%

Section: Lung Comet-tail Artifactmentioning

confidence: 99%

Section: Program Overviewmentioning

confidence: 99%

Section: Program Overviewmentioning

confidence: 99%

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Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Kimura

Amundson

Phan

et al. 2012

Journal of Hospital Medicine

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“…Hand-held ultrasound devices have been shown to significantly improve the physician's ability to detect a variety of disease states compared to the physical examination alone. [1][2][3][4] Although the use of ultrasound by clinicians is expanding, formal exposure to this technique during medical school is limited.…”

Section: Introductionmentioning

confidence: 99%

Adding New Tools to the Black Bag—Introduction of Ultrasound into the Physical Diagnosis Course

et al. 2010

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Point‐of‐care ultrasound: Closing guideline gaps in screening for valvular heart disease

Hammadah

Ponce

Sorajja

et al. 2020

Clinical Cardiology

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Background: A linear increase in the number of valvular heart disease is expected due to the aging population, yet most patients with severe valvular heart disease remain undiagnosed. Hypothesis: POCUS can serve as a screening tool for valvular heart disease. Methods: We reviewed the literature to assess the strengths and limitations of POCUS in screening and diagnosing valvular heart disease. Results: POCUS is an accurate, affordable, accessible, and comprehensive tool. It has a fast learning curve and can prevent unnecessary and more expensive imaging. Challenges include training availability, lack of simplified screening protocols, and reimbursement. Large scale valvular screening data utilizing POCUS is not available. Conclusion: POCUS can serve as a screening tool and guide the management of patients with valvular heart disease. More data is needed about its efficacy and costeffectiveness in the screening of patients with valvular heart disease.

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Value of a Cardiovascular Limited Ultrasound Examination Using a Hand-Carried Ultrasound Device on Clinical Management in an Outpatient Medical Clinic

Cited by 56 publications

References 28 publications

Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Observations during development of an internal medicine residency training program in cardiovascular limited ultrasound examination

Adding New Tools to the Black Bag—Introduction of Ultrasound into the Physical Diagnosis Course

Point‐of‐care ultrasound: Closing guideline gaps in screening for valvular heart disease

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