title: Diagnostic accuracy of hospitalist-performed hand-carried ultrasound echocardiography after a brief training program.
abstract: BACKGROUND
  The duration of training needed for hospitalists to accurately perform hand-carried ultrasound echocardiography (HCUE) is uncertain.
  
  
  OBJECTIVE
  To determine the diagnostic accuracy of HCUE performed by hospitalists after a 27-hour training program.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Large public teaching hospital.
  
  
  METHODS
  A total of 322 inpatients referred for standard echocardiography (SE) between March and May 2007.
  
  
  METHODS
  Blinded to SE results, attending hospitalist physicians performed HCUE within hours of SE.
  
  
  METHODS
  Diagnostic characteristics of HCUE as a test for 6 cardiac abnormalities assessed by SE: left ventricular (LV) systolic dysfunction; severe mitral regurgitation (MR); moderate or severe left atrium (LA) enlargement; moderate or severe LV hypertrophy; medium or large pericardial effusion; and dilatation of the inferior vena cava (IVC).
  
  
  RESULTS
  A total of 314 patients underwent both SE and HCUE within a median time of 2.8 hours (25th to 75th percentiles, 1.4 to 5.1 hours). Positive and negative likelihood ratios for HCUE increased and decreased, respectively, the prior odds by 5-fold or more for LV systolic dysfunction, severe MR regurgitation, and moderate or large pericardial effusion. Likelihood ratios changed the prior odds by 2-fold or more for moderate or severe LA enlargement, moderate or severe LV hypertrophy, and IVC dilatation. Indeterminate HCUE results occurred in 2% to 6% of assessments.
  
  
  CONCLUSIONS
  The diagnostic accuracy of HCUE performed by hospitalists after a brief training program was moderate to excellent for 6 important cardiac abnormalities.
authors: Department of Medicine, Stroger Hospital of Cook County and Rush Medical College, Chicago, Illinois, USA. brian_lucas@rush.edu
authors: Brian P
authors: BP
authors: Lucas
authors: Carolina
authors: C
authors: Candotti
authors: Bosko
authors: B
authors: Margeta
authors: Arthur T
authors: AT
authors: Evans
authors: Benjamin
authors: B
authors: Mba
authors: Joshua
authors: J
authors: Baru
authors: Joseph K
authors: JK
authors: Asbury
authors: Abdo
authors: A
authors: Asmar
authors: Rudolf
authors: R
authors: Kumapley
authors: Manish
authors: M
authors: Patel
authors: Shane
authors: S
authors: Borkowsky
authors: Sharon
authors: S
authors: Fung
authors: Marjorie
authors: M
authors: Charles-Damte
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards; D015331:Cohort Studies; D019719:Diagnostic Equipment / Q000592:standards; D004452:Echocardiography / Q000295:instrumentation* / Q000592:standards*; D005260:Female; D020445:Hospitalists / Q000193:education* / Q000592:standards*; D006801:Humans; D007318:Inservice Training / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000000981:diagnostic imaging