title: Pocket-size imaging device: effectiveness for ward-based transthoracic studies.
abstract: OBJECTIVE
  Pocket-size imaging devices (PSID) are now available; their potential role in a hospital environment has been investigated but still remains undefined.
  
  
  RESULTS
  We evaluated the effectiveness of PSID in 92 patients referred for bedside transthoracic echocardiogram (TTE). Patients were included where there was a focused clinical question: quantification of left ventricular function (LVF); presence of regional wall motion abnormalities (RWMA); evidence of pericardial effusion, exclusion of significant valve pathology. Each patient underwent an echocardiography evaluation using PSID and TTE. In 83 patients [k = 90%, 95% CI (82.2-95.4)], it was possible to answer the clinical question by PSID examination alone. There was agreement between the findings of PSID and TTE in 86 cases [79%; k = 47%, 95% CI (12.8-82.0)], in three cases, the clinical question was not answered by both modalities. When the clinical question was focused on LVF, the agreement was excellent [k = 96%, 95% CI (95.3-97.9)], as was the agreement in the detection of RWMA [k = 94.57%, 95% CI (82.4-95.1)]. There was also good concordance in the detection of valve pathology and pericardial effusion. Using PSID, the reduction in the scanning and reporting time was 66%. The cost-effectiveness analysis produced very favourable results: with PSE, we obtained an overall cost saving per scan of 76%, compared with TTE.
  
  
  CONCLUSIONS
  This study demonstrates that PSID can provide a valuable alternative to TTE in the presence of focused clinical questions and can provide an efficient way of delivering a ward-based transthoracic echo service.
authors.affiliation: King's College Hospital, London, UK.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gianstefani
authors.forename: Norman
authors.initials: N
authors.lastname: Catibog
authors.forename: Almira R
authors.initials: AR
authors.lastname: Whittaker
authors.forename: Antonios G
authors.initials: AG
authors.lastname: Ioannidis
authors.forename: Francesco
authors.initials: F
authors.lastname: Vecchio
authors.forename: Peter T
authors.initials: PT
authors.lastname: Wathen
authors.forename: Abdel
authors.initials: A
authors.lastname: Douiri
authors.forename: Joseph
authors.initials: J
authors.lastname: Reiken
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Monaghan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000379:methods; D004452:Echocardiography / Q000191:economics* / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design / Q000191:economics; D004869:Equipment Safety / Q000191:economics; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization / Q000379:methods*; D015588:Observer Variation; D019095:Point-of-Care Systems / Q000191:economics / Q000639:trends*; D015203:Reproducibility of Results; D006113:United Kingdom
keywords: Cost-effectiveness; Pocket-size imaging devices; Transthoracic echocardiogram