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J Perinatol. 2007 May;27(5):291-6. Epub 2007 Mar 15.

Diagnosis of patent ductus arteriosus by a neonatologist with a compact, portable ultrasound machine.

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1
Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA 94304, USA.

Abstract

OBJECTIVES:

To conduct a pilot study assessing a neonatologist's accuracy in diagnosing patent ductus arteriosus (PDA) using compact, portable ultrasound after limited training.

STUDY DESIGN:

Prospective study of premature infants scheduled for echocardiography for suspected PDA. A neonatologist with limited training performed study exams before scheduled exams. Sensitivity and specificity were calculated, compared to the scheduled echocardiogram interpreted by a cardiologist.

RESULTS:

There were 24 exams. Compared to the scheduled exam, the neonatologist's exam had sensitivity 69% (95% confidence interval (CI), 41 to 89%) and specificity 88% (95% CI, 47 to 99%). When a cardiologist interpreted the study exams, the sensitivity was 87% (95% CI, 60 to 98%) and specificity 71% (95% CI, 29 to 96%).

CONCLUSION:

A neonatologist with limited training was able to detect PDA with moderate success. A more rigorous training process or real-time transmission with cardiologist interpretation may substantially improve accuracy. Institutions with experienced technicians and on-site pediatric cardiologists may not gain from intensive training of neonatologists, but hospitals where diagnosis and treatment of PDA would be delayed may benefit from such processes.

PMID:
17363908
DOI:
10.1038/sj.jp.7211693
[Indexed for MEDLINE]
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