Félix Amiot, Thomas Delomas, François-Xavier Laborne, Thomas Ecolivet, Richard Macrez, Axel Benhamed
{"title":"全科医生对下呼吸道感染实施肺部超声波检查：一项可行性研究。","authors":"Félix Amiot, Thomas Delomas, François-Xavier Laborne, Thomas Ecolivet, Richard Macrez, Axel Benhamed","doi":"10.1080/02813432.2024.2343678","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility of lung ultrasonography (LUS) performed by novice users' general practitioners (GPs) in diagnosing lower respiratory tract infections (LRTIs) in primary health care settings.</p><p><strong>Design: </strong>A prospective interventional multicenter study (December 2019-March 2020).</p><p><strong>Settings and subjects: </strong>Patients aged >3 months, suspected of having LRTI consulting in three different general practices (GPs) (rural, semirural and urban) in France.</p><p><strong>Main outcome measures: </strong>Feasibility of LUS by GPs was assessed by (1) the proportion of patients where LUS was not performed, (2) technical breakdowns, (3) interpretability of images by GPs, (4) examination duration and (5) patient perception and acceptability.</p><p><strong>Results: </strong>A total of 151 patients were recruited, and GPs performed LUS for 111 (73.5%) patients (LUS group). In 99.1% (<i>n</i> = 110) of cases, GPs indicated that they were able to interpret images. The median [IQR] exam duration was 4 [3-5] minutes. LRTI was diagnosed in 70.3% and 60% of patients in the LUS and no-LUS groups, respectively (<i>p</i> = .43). After LUS, GPs changed their diagnosis from 'other' to 'LRTI' in six cases (+5.4%, <i>p</i> < .001), prescribed antibiotics for five patients (+4.5%, <i>p</i> = .164) and complementary chest imaging for 10 patients (+9%, <i>p</i> < .001). Patient stress was reported in 1.8% of cases, 81.7% of patients declared that they better understood the diagnosis, and 82% of patients thought that the GP diagnosis was more reliable after LUS.</p><p><strong>Conclusions: </strong>LUS by GPs using handheld devices is a feasible diagnostic tool in primary health care for LRTI symptoms, demonstrating both effectiveness and positive patient reception.</p><p><strong>Trial registration number: </strong>Clinicaltrial.gov: NCT04602234, 20/10/2020.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332293/pdf/","citationCount":"0","resultStr":"{\"title\":\"Implementation of lung ultrasonography by general practitioners for lower respiratory tract infections: a feasibility study.\",\"authors\":\"Félix Amiot, Thomas Delomas, François-Xavier Laborne, Thomas Ecolivet, Richard Macrez, Axel Benhamed\",\"doi\":\"10.1080/02813432.2024.2343678\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the feasibility of lung ultrasonography (LUS) performed by novice users' general practitioners (GPs) in diagnosing lower respiratory tract infections (LRTIs) in primary health care settings.</p><p><strong>Design: </strong>A prospective interventional multicenter study (December 2019-March 2020).</p><p><strong>Settings and subjects: </strong>Patients aged >3 months, suspected of having LRTI consulting in three different general practices (GPs) (rural, semirural and urban) in France.</p><p><strong>Main outcome measures: </strong>Feasibility of LUS by GPs was assessed by (1) the proportion of patients where LUS was not performed, (2) technical breakdowns, (3) interpretability of images by GPs, (4) examination duration and (5) patient perception and acceptability.</p><p><strong>Results: </strong>A total of 151 patients were recruited, and GPs performed LUS for 111 (73.5%) patients (LUS group). In 99.1% (<i>n</i> = 110) of cases, GPs indicated that they were able to interpret images. The median [IQR] exam duration was 4 [3-5] minutes. LRTI was diagnosed in 70.3% and 60% of patients in the LUS and no-LUS groups, respectively (<i>p</i> = .43). After LUS, GPs changed their diagnosis from 'other' to 'LRTI' in six cases (+5.4%, <i>p</i> < .001), prescribed antibiotics for five patients (+4.5%, <i>p</i> = .164) and complementary chest imaging for 10 patients (+9%, <i>p</i> < .001). 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Implementation of lung ultrasonography by general practitioners for lower respiratory tract infections: a feasibility study.
Objective: To evaluate the feasibility of lung ultrasonography (LUS) performed by novice users' general practitioners (GPs) in diagnosing lower respiratory tract infections (LRTIs) in primary health care settings.
Design: A prospective interventional multicenter study (December 2019-March 2020).
Settings and subjects: Patients aged >3 months, suspected of having LRTI consulting in three different general practices (GPs) (rural, semirural and urban) in France.
Main outcome measures: Feasibility of LUS by GPs was assessed by (1) the proportion of patients where LUS was not performed, (2) technical breakdowns, (3) interpretability of images by GPs, (4) examination duration and (5) patient perception and acceptability.
Results: A total of 151 patients were recruited, and GPs performed LUS for 111 (73.5%) patients (LUS group). In 99.1% (n = 110) of cases, GPs indicated that they were able to interpret images. The median [IQR] exam duration was 4 [3-5] minutes. LRTI was diagnosed in 70.3% and 60% of patients in the LUS and no-LUS groups, respectively (p = .43). After LUS, GPs changed their diagnosis from 'other' to 'LRTI' in six cases (+5.4%, p < .001), prescribed antibiotics for five patients (+4.5%, p = .164) and complementary chest imaging for 10 patients (+9%, p < .001). Patient stress was reported in 1.8% of cases, 81.7% of patients declared that they better understood the diagnosis, and 82% of patients thought that the GP diagnosis was more reliable after LUS.
Conclusions: LUS by GPs using handheld devices is a feasible diagnostic tool in primary health care for LRTI symptoms, demonstrating both effectiveness and positive patient reception.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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