title: Diagnostic accuracy and cost-effectiveness of a pocket-sized transthoracic echocardiographic imaging device.
abstract: BACKGROUND
  The recently introduced pocket-sized portable transthoracic echocardiography (pTTE) is accurate for measurement of cardiac chamber size and function as well as for assessment of valvular regurgitation. This study aimed to compare the diagnostic accuracy of the pocket-sized pTTE with the standard TTE (sTTE) and assess its cost-effectiveness.
  
  
  OBJECTIVE
  The use of pocket-sized pTTE, as an initial screening tool, may be feasible, accurate and cost-effective in the diagnostic strategy of cardiac abnormalities.
  
  
  METHODS
  The study subjects were 200 patients scheduled for sTTE and an electrocardiogram (ECG). Each patient underwent pTTE examination with the Vscan (GE Medical Systems, Milwaukee, WI) immediately after sTTE. The findings of pTTE and the ECG were compared with the results of sTTE. Cost-effectiveness was calculated.
  
  
  RESULTS
  There was a strong agreement in the detection of abnormal findings between pTTE and sTTE (agreement = 90%), whereas the agreement between the ECG and sTTE was 65%. When pTTE or the ECG was used as an initial screening tool prior to sTTE, similar cost reduction was obtained (approximately 30%) by reducing the number of referrals for sTTE. However, the negative predictive value of a diagnostic strategy with pTTE (92%) was superior to that with an ECG (67%).
  
  
  CONCLUSIONS
  This study demonstrates that the pocket-sized pTTE provides accurate detection of cardiac structural and functional abnormalities beyond the ECG. In addition, the use of pTTE as an initial screening tool prior to sTTE is cost-effective, suggesting that the pocket-sized pTTE is poised to alter the current diagnostic strategy in clinical practice.
authors.affiliation: Department of Internal Medicine and Cardiology (Kitada), Osaka City University School of Medicine, Osaka, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Kitada
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hiroki
authors.initials: H
authors.lastname: Oe
authors.forename: Yukio
authors.initials: Y
authors.lastname: Abe
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Song
authors.forename: Marta
authors.initials: M
authors.lastname: Sitges
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shiota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D015150:Echocardiography, Doppler / Q000191:economics* / Q000295:instrumentation*; D004562:Electrocardiography; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D017048:Health Care Costs; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000191:economics; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D008904:Miniaturization; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index
references.citation: J Am Soc Echocardiogr. 2005 Jun;18(6):620-5
references.pmid: 15947762
references.citation: J Am Soc Echocardiogr. 2011 Feb;24(2):117-24
references.pmid: 21074362
references.citation: Eur J Echocardiogr. 2011 Sep;12(9):665-70
references.pmid: 21810825
references.citation: Cardiovasc Ultrasound. 2004 Nov 17;2:24
references.pmid: 15548326
references.citation: Circ J. 2009 Jun;73(6):1092-6
references.pmid: 19372623
references.citation: J Am Soc Echocardiogr. 2005 Dec;18(12):1440-63
references.pmid: 16376782
references.citation: J Am Coll Cardiol. 2001 Jun 15;37(8):2013-8
references.pmid: 11419879
references.citation: Lancet. 2011 Mar 26;377(9771):1077-84
references.pmid: 21435709
references.citation: Ultrasound Med Biol. 2011 May;37(5):798-804
references.pmid: 21458144
references.citation: Eur Heart J. 2006 Jan;27(2):193-200
references.pmid: 16267076
references.citation: Am Heart J. 1949 Feb;37(2):161-86
references.pmid: 18107386
references.citation: Eur Heart J. 2011 Feb;32(4):385-6
references.pmid: 21320907
references.citation: Echocardiography. 2007 Mar;24(3):228-36
references.pmid: 17313633
references.citation: J Am Soc Echocardiogr. 2003 Jul;16(7):777-802
references.pmid: 12835667
references.citation: Eur J Intern Med. 2012 Mar;23(2):185-91
references.pmid: 22284252
references.citation: Eur J Echocardiogr. 2009 Jun;10(4):537-42
references.pmid: 19252189
references.citation: JACC Cardiovasc Imaging. 2011 Aug;4(8):921
references.pmid: 21835386
references.citation: Eur Heart J. 2002 Oct;23(19):1516-21
references.pmid: 12242071
references.citation: Heart. 2007 Apr;93(4):470-5
references.pmid: 16940393
references.citation: J Am Soc Echocardiogr. 2009 Feb;22(2):107-33
references.pmid: 19187853
references.citation: N Engl J Med. 2004 Feb 12;350(7):647-54
references.pmid: 14960741
references.citation: Heart. 2003 Jul;89(7):727-30
references.pmid: 12807841
references.citation: J Am Soc Echocardiogr. 2011 Feb;24(2):111-6
references.pmid: 21126857
references.citation: Eur J Echocardiogr. 2006 Aug;7(4):275-83
references.pmid: 16005264
references.citation: Circulation. 1984 Oct;70(4):657-62
references.pmid: 6478568
references.citation: JACC Cardiovasc Imaging. 2011 May;4(5):460-7
references.pmid: 21565732
references.citation: J Am Soc Echocardiogr. 2000 Jul;13(7):674-9
references.pmid: 10887352
references.citation: Echocardiography. 2010 Aug;27(7):759-64
references.pmid: 20412264
references.citation: Eur Heart J. 1998 Jul;19(7):990-1003
references.pmid: 9717033
references.citation: Cardiovasc Ultrasound. 2010 Nov 26;8:51
references.pmid: 21110840