增强初级医生的能力:澳大利亚农村地区 AAA 超声筛查的可行性和有效性研究。

IF 1 4区 医学 Q4 PERIPHERAL VASCULAR DISEASE Vascular Pub Date : 2024-11-17 DOI:10.1177/17085381241301529
Mei Ping Melody Koo, Hansraj Riteesh Bookun
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引用次数: 0

摘要

目的:在大都市地区,通过超声波对 65 岁及以上的白种男性进行腹主动脉瘤(AAA)筛查已被证明具有成本效益。有证据表明,经过适当的培训,没有超声波检查经验的人也能进行准确的主动脉测量。本研究评估了初级医生经过短期培训后在农村医院进行可靠的 AAA 超声波筛查的能力,以弥补专科外科服务的不足:方法:三名初级医生参加了 2 小时的实用超声波培训,随后在一家地区医院对住院病人和社区志愿者进行了扫描。分析的重点是临床可接受的 5 毫米范围内的测量误差、扫描效率和动脉瘤检测准确性:结果:共纳入 71 名参与者。在筛查中,81.7%的差异在临床可接受范围内,住院患者扫描的准确率为72.7%,志愿者扫描的准确率为95.5%。随着超声技术的标准化,测量的可重复性明显提高,操作人员在检测动脉瘤方面的一致性极佳。值得注意的是,从住院病人组到志愿者组,扫描效率都有显著提高:结论:初级医生只需接受两小时的培训,就能高效、可重复地测量肾下主动脉直径,其水平可与经验丰富的超声技师媲美。建议进行为期一天的指导练习,以确保标准化的超声技术。这种方法为农村地区的专科放射服务提供了一种实用、经济高效的补充,在不建议取代专业超声技师的情况下提高了关键筛查程序的可及性。
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Empowering junior doctors: A study on the feasibility and efficacy of ultrasound AAA screening in rural Australia.

Purposes: Abdominal Aortic Aneurysm (AAA) screening via ultrasound in Caucasian males aged 65 and older has proven cost-effective in metropolitan areas. Evidence suggests that with adequate training, individuals without prior sonography experience can achieve accurate aortic measurements. This study evaluates the capability of junior doctors, after brief training, to conduct reliable AAA ultrasound screenings in a rural hospital setting, addressing the gap in speciality surgical services.

Methods: Three junior doctors participated in a 2-hour practical ultrasound training, subsequently performing scans on both inpatients and community volunteers at a regional hospital. The analysis focused on measurement discrepancies within a 5 mm clinically acceptable difference, scanning efficiency, and aneurysm detection accuracy.

Results: A total of 71 participants were included. Among the screenings, 81.7% fell within the clinically acceptable discrepancy range, with 72.7% accuracy in inpatient scans and 95.5% in volunteer scans. Measurement reproducibility improved significantly with the standardisation of ultrasound techniques, and there was excellent agreement among operators in detecting aneurysms. Notably, scanning efficiency improved from the inpatient group to the volunteer group with statistical significance.

Conclusions: Junior doctors demonstrated the ability to efficiently and reproducibly measure the infrarenal aortic diameter at a level comparable to experienced sonographers after only 2 hours of training. A single day of supervised practice is recommended to ensure standardised ultrasound technique. This approach offers a practical, cost-effective supplement to specialist radiology services in rural areas, enhancing access to critical screening procedures without proposing the replacement of professional sonographers.

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来源期刊
Vascular
Vascular 医学-外周血管病
CiteScore
2.30
自引率
9.10%
发文量
196
审稿时长
6-12 weeks
期刊介绍: Vascular provides readers with new and unusual up-to-date articles and case reports focusing on vascular and endovascular topics. It is a highly international forum for the discussion and debate of all aspects of this distinct surgical specialty. It also features opinion pieces, literature reviews and controversial issues presented from various points of view.
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