maging and Diagnostic Testing easibility of point - of - care echocardiography by nternal medicine house staff

bjective To determine whether internal medicine house staff with limited training in echocardiography can use oint-of-care echocardiography to make simple, clinically important diagnoses. ackground Availability of small, portable ultrasound devices could make point-of-care echocardiography widely vailable. The training required to perform point-of-care echocardiography has not been established. ethods Medical house staff participated in a 3-hour point-of-care echocardiography training program. Patients cheduled for standard echocardiography as part of clinical care underwent point-of-care echocardiography within 24 ours to assess four common clinically important diagnoses. Each standard echocardiogram was interpreted twice. Agreeent ( ) was calculated between point-of-care and standard echocardiography by using standard echocardiography as he gold standard and between the two interpretations of standard echocardiography. esults Agreement ( ) between point-of-care echocardiography and standard echocardiography was 75% (0.51) for eft ventricular dysfunction (ejection fraction 55%), 79% (0.31) for moderate or severe mitral regurgitation, 92% (0.32) or aortic valve thickening or immobility, and 98% (0.51) for moderate or large pericardial effusion. Agreement between he two interpretations of standard echocardiography was 83% (0.63) for left ventricular dysfunction, 92% (0.68) for oderate or severe mitral regurgitation, 95% (0.62) for aortic valve thickening or immobility, and 97% (0.53) for moderte or large pericardial effusion. onclusions Medical house staff with limited training in echocardiography can use point-of-care echocardiography o assess left ventricular function and pericardial effusion with moderate accuracy that is lower than that of standard echoardiography. Assessment of valvular disease and other diagnoses likely requires more training and/or experience in chocardiography. (Am Heart J 2004;147:476–81.)