Emanuele König Klever, Gabriela de Oliveira Laguna Silva, Mariana Motta Dias da Silva, Jacqueline Castro da Rocha, Márcio Gustavo Santanna da Silva, Maria Eulália Vinadé Chagas, Jerusa da Rosa de Amorim, Aristóteles de Almeida Pires, Daniella Cunha Birriel, Hilda Maria Rodrigues Moleda Constant, Taís de Campos Moreira, Felipe Cezar Cabral
{"title":"重症监护室的远程医疗超声检查:诊断准确性试点研究。","authors":"Emanuele König Klever, Gabriela de Oliveira Laguna Silva, Mariana Motta Dias da Silva, Jacqueline Castro da Rocha, Márcio Gustavo Santanna da Silva, Maria Eulália Vinadé Chagas, Jerusa da Rosa de Amorim, Aristóteles de Almeida Pires, Daniella Cunha Birriel, Hilda Maria Rodrigues Moleda Constant, Taís de Campos Moreira, Felipe Cezar Cabral","doi":"10.1177/1742271X241264178","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Digital health is an opportune way of facilitating the implementation of point-of-care ultrasound (POCUS) in intensive care units (ICUs) of the Brazilian Unified Health System (SUS) through remote tele-mentored ultrasound (RTMUS). Therefore, this pilot diagnostic accuracy study aims to evaluate the sensitivity and specificity of RTMUS, using POCUS as the gold standard for the diagnosis of pulmonary oedema. As a secondary objective, these metrics will be assessed for pneumonia, chronic obstructive pulmonary disease (COPD), pneumothorax, pulmonary embolism, and cardiac tamponade.</p><p><strong>Methods: </strong>The study was conducted in three adult ICUs, monitored by the TeleUTI project, and included 23 patients who underwent POCUS carried out by an ICU medical professional and RTMUS carried out by a tele-intensivist from the institution that proposed the project.</p><p><strong>Results: </strong>The accuracy in diagnosing pulmonary oedema was 71.43%, COPD 89.96%, and for pneumonia, the results showed an accuracy of 65.22%. Analyses demonstrated that RTMUS has the same capability as POCUS for detecting true positive cases of pulmonary oedema, the same results of true negative cases for COPD, and a limitation in performance for pneumonia.</p><p><strong>Conclusions: </strong>For COPD and pulmonary oedema, remote examination can support healthcare teams, suggesting that RTMUS has the potential to be a substitute for POCUS. We emphasise that the results should be interpreted within the context of the study, which is considered small and should be validated on a larger scale to consolidate the conclusions.</p>","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":" ","pages":"1742271X241264178"},"PeriodicalIF":0.8000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565499/pdf/","citationCount":"0","resultStr":"{\"title\":\"Telemedicine ultrasound in intensive care unit: A pilot diagnostic accuracy study.\",\"authors\":\"Emanuele König Klever, Gabriela de Oliveira Laguna Silva, Mariana Motta Dias da Silva, Jacqueline Castro da Rocha, Márcio Gustavo Santanna da Silva, Maria Eulália Vinadé Chagas, Jerusa da Rosa de Amorim, Aristóteles de Almeida Pires, Daniella Cunha Birriel, Hilda Maria Rodrigues Moleda Constant, Taís de Campos Moreira, Felipe Cezar Cabral\",\"doi\":\"10.1177/1742271X241264178\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Digital health is an opportune way of facilitating the implementation of point-of-care ultrasound (POCUS) in intensive care units (ICUs) of the Brazilian Unified Health System (SUS) through remote tele-mentored ultrasound (RTMUS). Therefore, this pilot diagnostic accuracy study aims to evaluate the sensitivity and specificity of RTMUS, using POCUS as the gold standard for the diagnosis of pulmonary oedema. As a secondary objective, these metrics will be assessed for pneumonia, chronic obstructive pulmonary disease (COPD), pneumothorax, pulmonary embolism, and cardiac tamponade.</p><p><strong>Methods: </strong>The study was conducted in three adult ICUs, monitored by the TeleUTI project, and included 23 patients who underwent POCUS carried out by an ICU medical professional and RTMUS carried out by a tele-intensivist from the institution that proposed the project.</p><p><strong>Results: </strong>The accuracy in diagnosing pulmonary oedema was 71.43%, COPD 89.96%, and for pneumonia, the results showed an accuracy of 65.22%. Analyses demonstrated that RTMUS has the same capability as POCUS for detecting true positive cases of pulmonary oedema, the same results of true negative cases for COPD, and a limitation in performance for pneumonia.</p><p><strong>Conclusions: </strong>For COPD and pulmonary oedema, remote examination can support healthcare teams, suggesting that RTMUS has the potential to be a substitute for POCUS. 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Telemedicine ultrasound in intensive care unit: A pilot diagnostic accuracy study.
Introduction: Digital health is an opportune way of facilitating the implementation of point-of-care ultrasound (POCUS) in intensive care units (ICUs) of the Brazilian Unified Health System (SUS) through remote tele-mentored ultrasound (RTMUS). Therefore, this pilot diagnostic accuracy study aims to evaluate the sensitivity and specificity of RTMUS, using POCUS as the gold standard for the diagnosis of pulmonary oedema. As a secondary objective, these metrics will be assessed for pneumonia, chronic obstructive pulmonary disease (COPD), pneumothorax, pulmonary embolism, and cardiac tamponade.
Methods: The study was conducted in three adult ICUs, monitored by the TeleUTI project, and included 23 patients who underwent POCUS carried out by an ICU medical professional and RTMUS carried out by a tele-intensivist from the institution that proposed the project.
Results: The accuracy in diagnosing pulmonary oedema was 71.43%, COPD 89.96%, and for pneumonia, the results showed an accuracy of 65.22%. Analyses demonstrated that RTMUS has the same capability as POCUS for detecting true positive cases of pulmonary oedema, the same results of true negative cases for COPD, and a limitation in performance for pneumonia.
Conclusions: For COPD and pulmonary oedema, remote examination can support healthcare teams, suggesting that RTMUS has the potential to be a substitute for POCUS. We emphasise that the results should be interpreted within the context of the study, which is considered small and should be validated on a larger scale to consolidate the conclusions.
UltrasoundRADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.70
自引率
0.00%
发文量
55
期刊介绍:
Ultrasound is the official journal of the British Medical Ultrasound Society (BMUS), a multidisciplinary, charitable society comprising radiologists, obstetricians, sonographers, physicists and veterinarians amongst others.