Feasibility and Utility of Point-Of-Care Ultrasound (POCUS) in Primary Care Practice. EKOAP Pilot Study

Abstract

Objective: To evaluate the feasibility and utility of point-of-care ultrasound (POCUS) in primary care (PC) practice, considering use, findings and diagnostic coincidence. Methodology: Pilot study of a cross-sectional multicentre nature, registering ultrasounds (July 21-July 22) of six family doctors with experience in POCUS. Variables: age/sex, characteristics of ultrasounds (type, duration, location), diagnostic-therapeutic referrals/interventions, findings and diagnostic coincidence (five months of monitoring). Analysis: Statistical single-variate-inference, bivariate-association of variables, logistical regression (dependent variable: ultrasound alterations); 0.05 significance. Data exported from Excel to SPSS-25 for their analysis. Results: A total of 547 ultrasounds. Mean age 54.3±18.8 years, 55% women. Different duration according to modality: abdominal/ pelvic/urological (37.1% of the total) 13.9±5.2 minutes, osteoarticular (25.8%) 11.8±3.6, soft tissue (20.7%) 8.7±3.5, p<0.001; others: pulmonary, vascular, thyroids/neck, testicle/gynaecological. Scheduled 73.0% vs. 27.0% immediate (mainly pulmonary, 61.9%) and vascular, p<0.001. With ultrasound alterations 65.1% (CI95% 61.9-68.9%) more frequent in osteoarticular 27.3%, soft tissue 21.2%, and urological 14.9%; associate with: modality (soft tissue OR with respect to abdominal/pelvic/urological of 19.9, CI95% 9.2-43.0; musculoskeletal OR 3.6, CI95% 2.2-6.1), p<0.001; being male (OR 1.8, CI95% 1.2-2.8, p=0.008); and age ≥80 years (OR 8.8, CI95% 3.2-24.1, p<0.001). With no ultrasound diagnostic coincidence 5.7% (CI95% 3.8-7.7%), associated with requesting further tests/referrals; two cases of carcinoma referred despite absence of ultrasound findings. Drainage/infiltration in 15 cases. Conclusions: The POCUS is shown to be feasible/compatible with the PC practice (duration and modalities), useful (findings/diagnostic coincidence), safe (diagnostic coincidence/handling). The different care realities could limit the generalization of results, although it also reflects the versatility of the use of the POCUS; with need to explore/ broaden its potential applicability.