title: Use of hand-held ultrasound by a nonsonographer clinician to measure carotid intima-media thickness.
abstract: OBJECTIVE
  We sought to evaluate the accuracy of carotid intima-media thickness (CIMT) measurements by a nonsonographer clinician using hand-held ultrasound (HHU).
  
  
  BACKGROUND
  Use of a HHU for point-of-care CIMT measurement has not been tested previously.
  
  
  METHODS
  Participants underwent reference ultrasound and HHU studies. HHU validity was tested by an expert sonographer. Nonsonographer clinician accuracy using the HHU was tested against the expert sonographer. CIMT bioequivalence was tested with .5 pixel limits.
  
  
  RESULTS
  The 75 participants were (mean [SD]) 55 [7] years old. CIMT values were bioequivalent (0.714 [0.029] vs 0.685 [0.029] mm, phase I; 0.697 [0.015] vs 0.687 [0.015] mm, phase II; P(two 1-sided t test) < .05). Agreement was 80% for CIMT classifications (intraclass correlation coefficient = 0.451, P < .001) and 90% for plaque presence (intraclass correlation coefficient = 0.797, P < .001).
  
  
  CONCLUSIONS
  CIMT measured by HHU was bioequivalent to a reference ultrasound system, when used by an expert sonographer or nonsonographer clinician. Clinical classifications by CIMT quartile and plaque presence were similar. HHU may be suitable for office-based atherosclerosis screening.
authors.affiliation: University of Pennsylvania School of Medicine, Cardiovascular Medicine Division, Philadelphia, Pennsylvania, USA.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Tzou
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Korcarz
authors.forename: Susan E
authors.initials: SE
authors.lastname: Aeschlimann
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
mesh_terms: D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D008904:Miniaturization; D019095:Point-of-Care Systems; D011361:Professional Competence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods*