未经培训的患者能否在远程指导下自行进行皮肤和软组织超声波检查?

POCUS journal Pub Date : 2023-11-27 eCollection Date: 2023-01-01 DOI:10.24908/pocus.v8i2.16454
Ammar Saati, Arthur Au, Aditi U Joshi, Rebecca Davis, Frances Mae West, Resa E Lewiss
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摘要

研究目的本试验性研究旨在确定未接受过超声波检查培训的患者能否在模拟远程医疗会诊中,在远程临床医生的远程指导下自行扫描获取图像。本研究还试图描述患者在使用手持式超声波设备为自己进行超声波检查时的舒适度和障碍。研究方法这是一项单中心前瞻性观察队列研究,于 2021 年进行,为期 4 个月。如果患者之前未接受过使用超声波和使用远程引导的培训,则符合条件。他们自愿同意在一家门诊内科诊所参与研究。结果:20 名参与者接受了远程指导,对自己肘前窝的皮肤和软组织进行了超声检查。两名主题专家使用 "护理点超声图像质量量表 "对 6 秒钟的视频片段进行了评估。得分大于 7 分被认为足以进行诊断解释。平均分为 10.15/14,最低分为 5/14,最高分为 14/14,标准差 (SD) 为 2.39(采用双尾 Z 评分)。将阿尔法值设定为 0.05,95% CI 为(5.47-14.83)。结论在对 20 名没有超声波检查经验的参与者进行的试点研究中,未经培训的健康志愿者能够在受过培训的临床医生的远程指导下进行技术上可接受且可解释的超声波扫描。
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Can Untrained Patients Perform Their Own Skin and Soft Tissue Ultrasound Examination by Teleguidance?

Objectives: This pilot study aims to determine if patients untrained in performing ultrasound can self-scan to obtain images under remote clinician teleguidance during a simulated telehealth encounter. This study also seeks to describe the patients' comfort level and barriers to performing an ultrasound examination on themselves using a handheld ultrasound device. Methods: This was a single center prospective observational cohort study conducted over a 4-month period in 2021. Patients were eligible if they had no prior training in the use of ultrasound and in the use of teleguidance. They voluntarily consented to participate at a single ambulatory internal medicine clinic. Results: 20 participants were enrolled and underwent teleguidance to ultrasound their own skin and soft tissues at the antecubital fossae. Six second video clips were evaluated by 2 subject matter experts using the Point of Care Ultrasound Image Quality scale. A score >7 was considered adequate for diagnostic interpretation. The average score was 10.15/14, with a minimum score of 5/14, and maximum score of 14/14 and a standard deviation (SD) of 2.39 using a two tailed Z-score. Setting alpha at 0.05 the 95% CI was (5.47-14.83). Conclusion: In a pilot study of 20 participants with no ultrasound experience, untrained healthy volunteers were able to perform technically acceptable and interpretable ultrasound scans using teleguidance by a trained clinician.

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