Article
Reference
Point of care ultrasonography from the emergency department to the internal medicine ward: current trends and perspectives
LEIDI, Antonio Siro Gabriele, et al.
Abstract
The advent of portable devices in the early 80s has brought ultrasonography to the patient's bedside. Currently referred to as ‘point of care ultrasonography' (POCUS), it has become an essential tool for clinicians. Initially developed in the emergency and critical care settings, POCUS has gained increasing importance in internal medicine wards in the last decade, with both its growing diagnostic accuracy and portability making POCUS an optimal instrument for everyday clinical assessment and procedures. There is large body of evidence to confirm POCUS' superiority when compared to clinical examination and standard X-ray imaging in a variety of clinical situations. On the contrary, only few indications, such as procedural guidance, have a proven additional benefit for patients. Since POCUS is highly user-dependent, pre- and post-graduate curricula are needed and the range of use should be clearly defined. This review focuses on trends and perspectives of POCUS in the management of diseases frequently encountered in emergency and internal medicine. In addition, questions are raised regarding the teaching and supervision [...]
LEIDI, Antonio Siro Gabriele, et al . Point of care ultrasonography from the emergency department to the internal medicine ward: current trends and perspectives. Internal and Emergency Medicine , 2020, vol. 15, no. 3, p. 395-408
DOI : 10.1007/s11739-020-02284-5 PMID : 32034674
Available at:
http://archive-ouverte.unige.ch/unige:152326
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Online Resource 1
Caption:
Sensitivity, specificity and reference list of diagnostic point-of-care ultrasonography Article title:
Point of Care Ultrasonography from the Emergency Department to the Internal Medicine Ward:
current Trends and Perspectives.
Journal Name:
Internal and Emergency Medicine Authors:
Antonio Leidi
a(ORCID ID: 0000-0002-3934-0104), Frédéric Rouyer
b, Christophe Marti
a, Jean-Luc Reny
a(ORCID ID: 0000-0002-7528-7363) , Olivier Grosgurin
a,ba. General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
b. Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
Corresponding author: Olivier.Grosgurin@hcuge.ch
Diagnostic POCUS application Diagnostic performance Reference
Sensitivity (95% CI) Specificity (95% CI)
Sinus Acute sinusitis a 0.71 (0.61-0.79) 0.83 (0.71-0.91) [1]
Eye
Optic nerve sheath Intracranial
hypertension 0.90 (0.80-0.95) 0.85 (0.73-0.93) [2]
Retinal detachment 0.94 (0.78-0.99) 0.96 (0.89-0.99) [3]
Trachea Tube placement 0.98 (0.97-0.99) 0.98 (0.95-0.99) [4]
Lung
Effusion b 0.94 (0.88-0.97) 0.98 (0.92-1.00) [5]
Pneumonia 0.78 (0.70–0.84) 0.95 (0.68–0.99) [6]
Acute heart failure a 0.88 (0.75-0.95) 0.90 (0.88-0.92) [7]
A-profile, with no PLAPS a 0.78 (0.67-0.86) 0.94 (0.89-0.97) [6]
Pneumothorax b 0.91 (0.86-0.94) 0.98 (0.97-0.99) [8]
Heart
Left systolic dysfunction a 0.84 (0.74-0.91) 0.89 (0.85-0.91) [9]
Pericardial effusion c 0.96 (0.90-0.99) 0.98 (0.96-0.99) [10]
Right ventricle dilatation c 0.92 (0.65-0.98) 0.99 (0.95-1.00) [11]
Abdomen
Inferior cava vein Fluid
responsiveness b 0.63 (0.56–0.69) 0.73 (0.67–0.78) [12]
FAST Blunt intra-abdominal injury b 0.82 (0.75-0.89) 0.99 (0.98-0.99) [13]
Ascites c 0.96 (0.87-0.99) 0.82 (0.59-0.94) [14]
Cholecystitis b 0.82-0.91 0.66-0.95 [15]
Gallbladder stones a 0.90 (0.86-0.93) 0.88 (0.84-0.91) [16]
Splenomegaly c 1.00 (0.57-1.00) 0.74 (0.57-0.85) [17]
MRI = magnetic resonance imaging; CT = computer tomography; MRR = medical record review; PLAPS = posterolateral alveolar and/or pleural syndrome; COPD = chronic obstructive pulmonary disease; TTE = transthoracic echocardiography; NI BP = non invasive blood pressure; FAST = focused assessment with sonography in trauma; US = ultrasonography. A reference list is available in Online Resource 1.
a Result from meta-analysis with no test for heterogeneity
b Result from meta-analysis with high heterogeneity (I² ≥75%)
c Result from single studies
Abdominal aortic aneurism 0.99 (0.96-1.00) 0.98 (0.97-0.99) [18]
Hydronephrosis c 0.81 (0.80-83) 0.59 (0.56-0.63) [19]
Nephrolithiasis b 0.70 (0.67-0.73) 0.75 (0.72-0.78) [20]
Small bowel obstruction b 0.92 (0.89-0.95) 0.97 (0.88-0.99) [21]
Appendicitis b 0.84 (0.72–0.92) 0.91 (0.85–0.95) [22]
Pneumoperitoneum c 0.96 (0.86–0.99) 0.82 (0.73–0.86) [23]
Pelvis
Bladder distention c 0.96 (0.79–0.99) 0.75 (0.53–0.90) [24]
Ectopic pregnancy b 0.99 (0.97-1.00) 0.42-0.90 [25]
Acute scrotal pain c 0.95 (0.78 to 0.99) 0.94 (0.72 to 0.99) [26]
Limbs
Tendon injury c 0.94 (0.73-1.00) 1.00 (0.92-1.00) [27]
Long bone fracture c 0.93 (0.75-0.99) 0.83 (0.65-0.94) [28]
Soft Tissue Abscess a 0.96 (0.89 to 0.98) 0.80 (0.56 to 0.93) [29]
Deep vein thrombosis b [30]
2-point 0.91 (0.68-0.98) 0.98 (0.96-0.99)
3-point 0.90 (0.83-0.95) 0.95 (0.83-0.99)
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