内科床旁临床手持超声波:Codogno 的 "Bed Med-Us "经验及其在 1007 名患者的诊断和治疗管理中的临床实用性。

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Ultrasound International Open Pub Date : 2024-01-05 DOI:10.1055/a-2196-1599
Francesco Giangregorio, Emilio Mosconi, Maria Grazia Debellis, Eliana Palermo, Stella Provini, Manuela Mendozza, Laura Ricevuti, Ciro Esposito
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引用次数: 0

摘要

目的 手持式超声波(HH-US)可解答急诊中的简单临床问题。我们在就诊期间(MED)在病人床边(BED)用 HH-US 进行了传统超声检查(BED MED-US)。这项前瞻性研究的目的是评估 BED MED-US 的可靠性、其在帮助临床医生做出正确诊断方面的临床效果以及其节省时间和金钱的能力。材料和方法 在一个或多个地区对 1007 名患者(519 名男性;年龄:76.42 岁)进行了评估(从 2021 年 3 月到 2022 年 11 月)。通过临床和参考检查(胸部 RX/CT、腹部 CT、内窥镜检查等)确定最终诊断。对敏感性、特异性、LR+ 和 LR- 以及相应的 AUROC 进行了评估。HH-US 诊断分为:确诊(HH-US 发现的超声波征象证实了临床诊断)(CO)、排除(HH-US 在临床鉴别诊断中排除了其他病变的超声波征象)(EX)、病因诊断(HH-US 在临床可疑病例中得出诊断)(ET)或临床相关附带诊断(HH-US 诊断完全改变了患者的病程)(INC)。结果 HH-US 可靠性:true-pos:真阳性:752 例;真阴性:242 例;假阳性:7 例;假阴性:6 例:7; false-neg: 6 (sens: 99.1%, spec: 97.6%, LR+: 98.5; LR-: 00.15, AUROC: 0.997);临床影响:临床影响:CO-诊断:21%;EX:25%;ET:47%;INC:7%;节省的时间和金钱:约 35,572 分钟的工作时间和 9324 欧元。结论 BED MED-US 是一种可靠的临床成像系统,在诊断(47% 为病因诊断,7% 为偶然诊断)和人力资源管理方面都具有重要的临床影响。
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Bedside Clinical Hand-held Ultrasound in an Internal Medicine Department: The "Bed Med-Us" Experience of Codogno and its Clinical Utility in the Management of Diagnosis and Therapy in 1007 Patients.

Purpose Handheld ultrasound (HH-US) answers simple clinical questions in emergencies. We performed conventional US with HH-US at the patient's bedside (BED) during a medical visit (MED) (BED MED-US). The purpose of this prospective study is to estimate BED MED-US reliability, its clinical impact in helping the clinician to formulate correct diagnoses, and its ability to save time and money. Materials and Methods 1007 patients (519 M; age:76.42) were assessed (from March 2021 to November 2022) in one or more districts. Final diagnosis was determined with clinical and reference tests (chest RX/CT, abdominal CT, endoscopy, etc.). Sensitivity, specificity, LR+ and LR-, and corresponding AUROC were evaluated. HH-US diagnoses were classified as: confirmation (HH-US revealed the sonographic signs that confirmed the clinical diagnosis) (CO), exclusion (HH-US excluded the presence of the ultrasound signs of other pathologies, in the clinical differential diagnosis) (EX), etiological (HH-US reaches diagnosis in clinically doubtful cases) (ET), or clinically relevant incidental (HH-US diagnoses that change the patient's process completely) (INC). Results HH-US reliability: true-pos: 752; true-neg: 242; false-pos: 7; false-neg: 6 (sens: 99.1%, spec: 97.6%, LR+: 98.5; LR-: 00.15, AUROC: 0.997); clinical impact: CO-diagnosis: 21%; EX: 25%; ET: 47%; INC: 7%; saved time and money: approximately 35,572 minutes of work and 9324 euros. Conclusion BED MED-US is a reliable clinical imaging system, with an important clinical impact both in diagnosis (etiological in 47%, incidental in 7%) and in the management of personnel resources.

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来源期刊
Ultrasound International Open
Ultrasound International Open RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
3.00
自引率
0.00%
发文量
7
审稿时长
12 weeks
期刊最新文献
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