Primary care POCUS on the Old Continent: Guidance needed, but at least 1 use case deemed ‘useful and feasible’
Two European studies illustrate opportunities and challenges presented by the growing appeal of point-of-care ultrasound to primary care practices.
Both studies are current in Annals of Family Medicine.
In one study, conducted at Aalborg University in Denmark, researchers found a quarter of 20 surveyed general practices using POCUS for exploratory purposes with or without a suspected diagnosis [1].
Further, despite unanimous agreement on their specialty’s need for formal POCUS training, 75% had used the modality to perform diagnostic scans of anatomic areas for which they’d received no POCUS training.
In their discussion, the authors comment:
We found a difference between the ideas about the appropriate uses for ultrasound in general practice and the actual use by early adopters in clinical practice. Our findings suggest a need for evidence-based guidelines to support general practitioners in choosing which examinations to perform and strategies for developing and maintaining scanning competency.”
The study is posted in full for free.
In another study, this one carried out in Spain at Galapagar Primary Care Center in Madrid, researchers compared lung ultrasound findings in primary care with subsequent chest x-ray reports from radiologists for diagnosing community-acquired pneumonia.
Prospectively observing POCUS use for this indication for 82 patients seen by 28 clinicians at 12 primary care centers, the authors found 88% sensitivity as well as good concordance between doctor-office POCUS and radiologist-read chest x-rays [2].
They further found little difference in diagnostic accuracy between PCPs trained in or experienced with POCUS and their inexperienced and untrained peers.
From the team’s discussion:
Point-of-care lung ultrasound in primary care for patients with nonsevere symptoms having suspected community-acquired pneumonia seems to be useful and feasible, and our results let us propose an algorithm to guide decision making. … Although we compared lung ultrasound with chest radiography (which could be considered a suboptimal reference), and larger and longer studies are needed to reproduce the findings, our study suggests that implementing training programs and using lung ultrasound for suspected community-acquired pneumonia could be useful and feasible for family physicians and pediatricians working at primary care.”
Full study here.
More Coverage of Point-of-Care Ultrasound:
Cross-sectional imaging ordered downstream for just 15% of emergency POCUS patients
Radiologists must ditch ‘illusion’ of handling all POCUS exams, work with clinicians on path forward
Point-of-care ultrasound cuts costs and visit times for patients with developmental hip dysplasia
Radiology must change the payment paradigm for point-of-care ultrasound, experts charge
Focus on POCUS: Hey, Emergency Medicine and Radiology: Who’s in Charge Here?
References:
- Camilla Aakjær Andersen, Martin Bach Jensen et al., “General Practitioners’ Perspectives on Appropriate Use of Ultrasonography in Primary Care in Denmark: A Multistage Mixed Methods Study.” Annals of Family Medicine, May 2022. DOI: https://doi.org/10.1370/afm.2795
- Francisco Javier Rodríguez-Contreras, Carmelo Prieto-Zancudo, et al., “Lung Ultrasound Performed by Primary Care Physicians for Clinically Suspected Community-Acquired Pneumonia: A Multicenter Prospective Study.” Annals of Family Medicine, May 2022. DOI: https://doi.org/10.1370/afm.2796
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.