Programme no. 430-OP
The use of point-of-care ultrasound in general practice. A systematic review
Martin Bach Jensen*1, Jonathan Vela2
1Research Unit for General Practice in the North Denmark Region and Department of Clinical Medicine,Aalborg University, Denmark,9220 Aalborg,Denmark, 2Research Unit for General Practice in the North Denmark Region and Department of Clinical Medicine,Aalborg University, Denmark,9220 Aalborg,Denmark
* = Presenting author
To evaluate the literature regarding the use of point-of-care US in a GP setting and the training of general practitioners using point-of-care US. In addition to the clinical aspects, we aimed to include information regarding the patients’ perspective and economical aspects.
Background: The use of point-of-care ultrasound (US) is increasing in medical undergraduate training and in most clinical specialties including general practice (GP). Yet, we have found no review of the literature describing the use of US in GP.
Results: There is large heterogeneity in the reported training and use of point-of-care US by general practitioners, but active general practitioners who used US for a broad area of clinical application reported scanning 2-3 times a day. Generally the described quality of the scans was satisfactory and the time it took to do a point-of-care US examination was reasonable (often ≤10 minutes). That the general practitioner performs point-of-care US scan is in agreement with patients’ preferences. Furthermore, it is probably cost-effective. However, the risk of bias of the reported studies were rated as high as there were no randomized studies evaluating the use of point-of-care US by general practitioners and most studies had few participants who may not be representative for the majority of general practitioners.
Material/Methods: A review protocol was composed specifying search strategy, inclusion/exclusion criteria, and data extraction. By May 2014 we searched the databases Pubmed and Embase using search terms related to ultrasonography (US) and general practice (GP). We evaluated: 1. What was point-of-care US used for by general practitioners? 2. What training had the general practitioners received prior to using point-of-care US? 3. How often were scans done by general practitioners indicated? 4. How much extra time was used on point-of-care US done by general practitioners? 5. What was the quality of the scans performed by a general practitioner? 6. What was the patients’ perspective on scans done by general practitioners? 7. What are the economical aspects of point-of-care US done by general practitioners.
Conclusion: Generally, the use of point-of-care US in GP is reported as being advantageous. However, we need high quality studies that further describe the quality of the scans in broader groups of general practitioners, further explore how general practitioners should be trained to acquire and retain sufficient competence in point-of-care US, and evaluate the clinical course of patients exposed to scanning general practitioners
Points for discussion: What should we use point-of-care US for in GP and what training in point-of-care US should general practitioners have?