Empowering junior doctors: A study on the feasibility and efficacy of ultrasound AAA screening in rural Australia.

Abstract

Purposes: Abdominal Aortic Aneurysm (AAA) screening via ultrasound in Caucasian males aged 65 and older has proven cost-effective in metropolitan areas. Evidence suggests that with adequate training, individuals without prior sonography experience can achieve accurate aortic measurements. This study evaluates the capability of junior doctors, after brief training, to conduct reliable AAA ultrasound screenings in a rural hospital setting, addressing the gap in speciality surgical services.

Methods: Three junior doctors participated in a 2-hour practical ultrasound training, subsequently performing scans on both inpatients and community volunteers at a regional hospital. The analysis focused on measurement discrepancies within a 5 mm clinically acceptable difference, scanning efficiency, and aneurysm detection accuracy.

Results: A total of 71 participants were included. Among the screenings, 81.7% fell within the clinically acceptable discrepancy range, with 72.7% accuracy in inpatient scans and 95.5% in volunteer scans. Measurement reproducibility improved significantly with the standardisation of ultrasound techniques, and there was excellent agreement among operators in detecting aneurysms. Notably, scanning efficiency improved from the inpatient group to the volunteer group with statistical significance.

Conclusions: Junior doctors demonstrated the ability to efficiently and reproducibly measure the infrarenal aortic diameter at a level comparable to experienced sonographers after only 2 hours of training. A single day of supervised practice is recommended to ensure standardised ultrasound technique. This approach offers a practical, cost-effective supplement to specialist radiology services in rural areas, enhancing access to critical screening procedures without proposing the replacement of professional sonographers.