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J Ultrasound Med. 2017 Jun;36(6):1189-1194. doi: 10.7863/ultra.16.05073. Epub 2017 Mar 4.

Point-of-Care Ultrasound Use, Accuracy, and Impact on Clinical Decision Making in Rwanda Hospitals.

Author information

1
Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
2
Department of Emergency Medicine, Maine Medical Center, Portland, Maine, USA.
3
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
4
Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts, USA.
5
University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda.
6
Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

OBJECTIVES:

Few studies of point-of-care ultrasound training and use in low resource settings have reported the impact of examinations on clinical management or the longer-term quality of trainee-performed studies. We characterized the long-term effect of a point-of-care ultrasound program on clinical decision making, and evaluated the quality of clinician-performed ultrasound studies.

METHODS:

We conducted point-of-care ultrasound training for physicians from Rwandan hospitals. Physicians then used point-of-care ultrasound and recorded their findings, interpretation, and effects on patient management. Data were collected for 6 months. Trainee studies were reviewed for image quality and accuracy.

RESULTS:

Fifteen participants documented 1158 ultrasounds; 590 studies (50.9%) had matched images and interpretations for review. Abdominal ultrasound for free fluid was the most frequently performed application. The mean image quality score was 2.36 (95% confidence interval, 2.28-2.44). Overall sensitivity and specificity for trainee-performed examinations was 94 and 98%. Point-of-care ultrasound use most commonly changed medications administered (42.4%) and disposition (30%).

CONCLUSIONS:

A point-of-care ultrasound training intervention in a low-resource setting resulted in high numbers of diagnostic-quality studies over long-term follow-up. Ultrasound use routinely changed clinical decision making.

KEYWORDS:

education; global health; point of care; ultrasound

PMID:
28258591
DOI:
10.7863/ultra.16.05073
[Indexed for MEDLINE]

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