Influence of Routinely Adding Ultrasound Screening in Medical Department
Study Details
Study Description
Brief Summary
Ultrasound (US) is widely used as a diagnostic tool in a hospital setting. In a medical department, diagnosis like heart failure or most kinds of heart diseases, hypervolemia, hypovolemia, pleural effusion, pericardial effusion, ascites, diseases in the gall bladder/bile tract, urine tract and venous thrombosis are common. US is the key diagnostic tool in these diagnosis, and on early diagnosis is crucial with respect to the patients well-being and inpatients workflow.
- The aim is to study the clinical use of pocket-size US as a screening diagnostic tool in an medical department with respect to inpatients workflow and diagnostics.
Method: Patients admitted (in certain preset periods) to Department of medicine will be randomized to routinely adding an ultrasound examination with pocket-size device by residents on call. Time to definitive diagnosis, time to definitive treatment and time to discard will be recorded. US findings will be validated against standard echocardiography, or standard US/CT/MRI performed at the Radiological department.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Usual care Usual care diagnostics. No routinely ultrasound examination |
Other: Usual care
No intervention, except for usual care (goal-directed diagnostics)
|
| Experimental: Routinely ulasonography Patients will routinely be examined with ultrasound at admittance in addition to usual care diagnostics |
Procedure: Pocket-size ultrasonography
Routinely adding a ultrasound examination of the heart, pleura, great abdominal vessels, liver/gall bladder and kidneys at patients admittance to hospital
|
Outcome Measures
Primary Outcome Measures
- Time to definitive diagnosis [3 months]
Time from admittance to definitive diagnosis
Secondary Outcome Measures
- Test-retest reproducibility [3 months]
Pocket-sized ultrasound recordings by residents will be validated against reference methods (echocardiography and radiologic examinations by sepcialists)to assess sensitivity, specificity, positive and negative predictive values of pocket-size ultrasound.
- Diagnostic outcome of additional ultrasound examination according to educational level of the performer [3 months]
Study the diagnostic outcome of ultrasound screening related to the educational level and skills of the user
- Time to definitive treatment [3 months]
Time from admittance to definitive treatment
- Time to discharge [3 months]
Time from patients admittance to discharge from hospital
Eligibility Criteria
Criteria
Inclusion Criteria:
- Patients admitted to Dep. of Medicine at Levanger Hospital
Exclusion Criteria:
- Not able to give informed consent
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Department of Medicine, Levanger Hospital, Nord-Trøndelag Health Trust | Levanger | Norway | 7600 |
Sponsors and Collaborators
- Helse Nord-Trøndelag HF
- Norwegian University of Science and Technology
Investigators
- Study Chair: Havard Dalen, MD, PhD, Levanger Hospital/Norwegian University of Science an Technology
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
- Kimura BJ, Shaw DJ, Agan DL, Amundson SA, Ping AC, DeMaria AN. Value of a cardiovascular limited ultrasound examination using a hand-carried ultrasound device on clinical management in an outpatient medical clinic. Am J Cardiol. 2007 Jul 15;100(2):321-5. Epub 2007 May 29.
- Lucas BP, Candotti C, Margeta B, Evans AT, Mba B, Baru J, Asbury JK, Asmar A, Kumapley R, Patel M, Borkowsky S, Fung S, Charles-Damte M. Diagnostic accuracy of hospitalist-performed hand-carried ultrasound echocardiography after a brief training program. J Hosp Med. 2009 Jul;4(6):340-9. doi: 10.1002/jhm.438.
- Martin LD, Howell EE, Ziegelstein RC, Martire C, Whiting-O'Keefe QE, Shapiro EP, Hellmann DB. Hand-carried ultrasound performed by hospitalists: does it improve the cardiac physical examination? Am J Med. 2009 Jan;122(1):35-41. doi: 10.1016/j.amjmed.2008.07.022.
- Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011 Feb 24;364(8):749-57. doi: 10.1056/NEJMra0909487. Review.
- Prinz C, Voigt JU. Diagnostic accuracy of a hand-held ultrasound scanner in routine patients referred for echocardiography. J Am Soc Echocardiogr. 2011 Feb;24(2):111-6. doi: 10.1016/j.echo.2010.10.017. Epub 2010 Dec 3.
- Roelandt JR. Ultrasound stethoscopy. Eur J Intern Med. 2004 Oct;15(6):337-347.
- Sicari R, Galderisi M, Voigt JU, Habib G, Zamorano JL, Lancellotti P, Badano LP. The use of pocket-size imaging devices: a position statement of the European Association of Echocardiography. Eur J Echocardiogr. 2011 Feb;12(2):85-7. doi: 10.1093/ejechocard/jeq184. Epub 2011 Jan 7.
- LH-2011-1