title: Stethoscope versus point-of-care ultrasound in the differential diagnosis of dyspnea: a randomized trial.
abstract: We aimed to determine the accuracies of point-of-care ultrasound (PoCUS) and stethoscopes as part of the physical examinations of patients with dyspnea. Three emergency medicine specialists in each of two groups of ultrasound and stethoscope performers underwent didactic and hands-on training on PoCUS and stethoscope usage. All the patients enrolled were randomized to one of two predetermined PoCUS or stethoscope groups. The diagnostic performance of ultrasonography was higher than that of the stethoscope in the diagnoses of heart failure (90 vs. 86%, 1.00 vs. 0.89, and 5.00 vs. 4.92, respectively) and pneumonia (90 vs. 86.7%, 0.75 vs. 0.73, and 16.50 vs. 13.82, respectively). No significant differences were observed in the utility parameters of these modalities in these diagnoses. Although some authors argue that it is time to abandon the 'archaic tools' of past centuries, we believe that it is too early to discontinue the use of the stethoscope.
authors.affiliation: aDepartment of Pediatric Endocrinology, İzmir South Area Public Hospitals Association Departments of bEmergency cCardiology dRadiology ePulmonology, İzmir Katip Çelebi University Atatürk Research and Training Hospital fDepartment of Emergency, İzmir Karşiyaka State Hospital, İzmir gDepartment of Emergency, Kartal Lütfi Kirdar Research and Training Hospital, İstanbul, Turkey.
authors.forename: Behzat
authors.initials: B
authors.lastname: Özkan
authors.forename: Erden E
authors.initials: EE
authors.lastname: Ünlüer
authors.forename: Pinar Y
authors.initials: PY
authors.lastname: Akyol
authors.forename: Arif
authors.initials: A
authors.lastname: Karagöz
authors.forename: Mehmet S
authors.initials: MS
authors.lastname: Bayata
authors.forename: Haldun
authors.initials: H
authors.lastname: Akoğlu
authors.forename: Orhan
authors.initials: O
authors.lastname: Oyar
authors.forename: Ayşe
authors.initials: A
authors.lastname: Dalli
authors.forename: Fatih E
authors.initials: FE
authors.lastname: Topal
mesh_terms: D002983:Clinical Competence; D016001:Confidence Intervals; D016638:Critical Illness; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology; D015150:Echocardiography, Doppler / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000193:education; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D010808:Physical Examination / Q000379:methods; D019095:Point-of-Care Systems; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis*; D019023:Stethoscopes / Q000706:statistics & numerical data*