Diagnosis of patent ductus arteriosus by a neonatologist with a compact, portable ultrasound machine.
OBJECTIVE
To conduct a pilot study assessing a neonatologist's accuracy in diagnosing patent ductus arteriosus (PDA) using compact, portable ultrasound after limited training.


METHODS
Prospective study of premature infants scheduled for echocardiography for suspected PDA. A neonatologist with limited training performed study exams before scheduled exams. Sensitivity and specificity were calculated, compared to the scheduled echocardiogram interpreted by a cardiologist.


RESULTS
There were 24 exams. Compared to the scheduled exam, the neonatologist's exam had sensitivity 69% (95% confidence interval (CI), 41 to 89%) and specificity 88% (95% CI, 47 to 99%). When a cardiologist interpreted the study exams, the sensitivity was 87% (95% CI, 60 to 98%) and specificity 71% (95% CI, 29 to 96%).


CONCLUSIONS
A neonatologist with limited training was able to detect PDA with moderate success. A more rigorous training process or real-time transmission with cardiologist interpretation may substantially improve accuracy. Institutions with experienced technicians and on-site pediatric cardiologists may not gain from intensive training of neonatologists, but hospitals where diagnosis and treatment of PDA would be delayed may benefit from such processes.
Lee
H C
HC
Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, CA 94304, USA.
Silverman
N
N
Hintz
S R
SR
D002309:Cardiology; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging*; D008297:Male; D009359:Neonatology; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012017:Referral and Consultation; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000295:instrumentation*