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Do pocket-sized ultrasound machines have the potential to be used as a tool to triage patients in obstetrics and gynecology?
MedLine Citation:
PMID:  22605511     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives To evaluate the performance and potential impact on patient management of a pocket-sized ultrasound machine (PUM) in comparison to high specification ultrasound machines (HSUM). Methods An observational cohort study on 204 unselected patients in three categories: 1) early pregnancy pain and bleeding (101 patients), 2) late pregnancy routine assessment (53 patients), and 3) possible gynecological pathology (50 patients). Scans were carried out transabdominally using the pocket-sized ultrasound machine (PUM). A second operator repeated the examination transvaginally and/or transabdominally, depending on the clinical indication, using a high specification ultrasound machine (HSUM). The operators were blind to each other's findings. Results In the early pregnancy group, there was good to very good agreement between PUM and HSUM for identifying the presence or absence of an embryo, gestational sac, fetal heart motion, pregnancy location, and final diagnostic outcome (Kappa coefficient was 0.844, 0.843, 0.729, 0.785, and 0.812 respectively, p<0.0001). In late pregnancy there was good to very good agreement for fetal presentation, placental location, and placental position (Kappa coefficient of 0.924, 0.924, and 0.647 respectively, p< 0.0001). In the gynecology group, there was very good agreement for final diagnosis, and type of ovarian mass (low risk, complex) (Kappa coefficient of 0.846, and 0.930 respectively, p<0.0001). For the measured continuous variables, there was close agreement for crown-rump length, mean sac diameter, femur length, and mean diameter of an ovarian mass, but not for endometrial thickness. Patient age, BMI, operator experience, and familiarity with PUM had no impact on agreement between the two machines. If a PUM had been the only equipment available for an initial assessment, only two cases would have led to a suboptimal patient management plan. Conclusion The findings and final diagnosis in the three study groups were similar for both a PUM used transabdominally and a HSUM used transvaginally and/or transabdominally. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
A Sayasneh; J Preisler; A Smith; S Saso; O Naji; Y Abdallah; C Stalder; A Daemen; D Timmerman; T Bourne
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-17
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Early pregnancy and gynaecological scanning unit, Queen Charlotte's and Chelsea Hospital, Imperial College, Du Cane Road, London, UK. a.sayasneh@imperial.ac.uk.
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