title: Clinical utility and cost effectiveness of a personal ultrasound imager for cardiac evaluation during consultation rounds in patients with suspected cardiac disease.
abstract: OBJECTIVE
  To assess the clinical utility and cost effectiveness of a personal ultrasound imager (PUI) during consultation rounds for cardiac evaluation of patients with suspected cardiac disease.
  
  
  METHODS
  107 unselected patients from non-cardiac departments (55% men) were enrolled in the study. After the physical examination the consultant cardiologist performed an echocardiographic study with a PUI. The final report was given instantly to the referring physician. All patients subsequently underwent a study with a standard echocardiographic device (SED). For each patient the consultant cardiologist noted whether the findings of the PUI were adequate for final diagnosis. The total cost when full echocardiography was used was compared with the cost when the PUI was used. The time interval from request to diagnosis was also compared.
  
  
  RESULTS
  In 84 (78.5%) patients no further examination with an SED was regarded as necessary. Twenty three patients (21.5%) required a further detailed examination with the SED because of the need for haemodynamic information. There was an excellent agreement for the detection of abnormalities between the two devices (96%). The total cost was euro;132 per patient with the SED and euro;75 per patient with the PUI. According to this study, the use of the PUI can lead to a 33.4% reduction of total cost. The mean time from request to diagnosis at the authors' institution was four days for the SED and instantly for the PUI, for additional potential cost savings.
  
  
  CONCLUSIONS
  Immediate echocardiographic assessment during consultation rounds can lead to significant cost savings and can shorten the time to diagnosis.
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, Netherlands.
authors.forename: E C
authors.initials: EC
authors.lastname: Vourvouri
authors.forename: L Y
authors.initials: LY
authors.lastname: Koroleva
authors.forename: F J
authors.initials: FJ
authors.lastname: Ten Cate
authors.forename: D
authors.initials: D
authors.lastname: Poldermans
authors.forename: A F L
authors.initials: AF
authors.lastname: Schinkel
authors.forename: R T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: W B
authors.initials: WB
authors.lastname: Vletter
authors.forename: J R T C
authors.initials: JR
authors.lastname: Roelandt
mesh_terms: D000553:Ambulatory Care; D003362:Cost-Benefit Analysis; D004452:Echocardiography / Q000295:instrumentation*; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D019095:Point-of-Care Systems