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Point-of-care ultrasound in primary care
Previously, ultrasound examinations have been performed by specialized personnel using advanced scanning devices. But with the current development in technology the devices are now smaller, more portable as well as cheaper, and thus more available also to clinicians in primary care.
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Publication type:
Question
What scientific studies are there investigating the use of point-of-care ultrasound in primary care?
Identified literature
One systematic review with high risk of bias [1] and eight primary studies [2-9] were found relevant for the question. The primary studies were not assessed for risk of bias.
References
- Andersen CA, Holden S, Vela J, Rathleff MS, Jensen MB. Point-of-Care Ultrasound in General Practice: A Systematic Review. Ann Fam Med 2019;17:61-69.
- Blois B. Office-based ultrasound screening for abdominal aortic aneurysm. Can Fam Physician 2012;58:e172-8.
- Bornemann P, Johnson J, Tiglao S, Moghul A, Swain S, Bornemann G, et al. Assessment of Primary Care Physicians' Use of a Pocket Ultrasound Device to Measure Left Ventricular Mass in Patients with Hypertension. J Am Board Fam Med 2015;28:706-12.
- Evangelista A, Galuppo V, Méndez J, Evangelista L, Arpal L, Rubio C, et al. Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation. Heart 2016;102:376-82.
- Greenlund LJS, Merry SP, Thacher TD, Ward WJ. Primary Care Management of Skin Abscesses Guided by Ultrasound. Am J Med 2017;130:e191-e193.
- Karjalainen JP, Riekkinen O, Kröger H, Jurvelin JS. Ultrasound method for osteoporosis diagnostics at primary healthcare. Osteoporos Int 2012;23:S244-S245.
- Karjalainen JP, Riekkinen O, Toyras J, Jurvelin JS, Kroger H. New method for point-of-care osteoporosis screening and diagnostics. Osteoporos Int 2016;27:971-7.
- Lindgaard K, Riisgaard L. 'Validation of ultrasound examinations performed by general practitioners'. Scand J Prim Health Care 2017;35:256-61.
- Nilsson G, Soderstrom L, Alverlind K, Samuelsson E, Mooe T. Hand-held cardiac ultrasound examinations performed in primary care patients by nonexperts to identify reduced ejection fraction. BMC Med Educ 2019;19:282.
Literature search
Search terms | Items found | |
The search result, usually found at the end of the documentation, forms the list of abstracts.; [mh] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [mh:noexp] = Does not include terms found below this term in the MeSH hierarchy; [majr] = MeSH Major Topic; [tiab] = Title or abstract; [ti] = Title; [au] = Author; [tw] = Text Word; Systematic[sb] = Filter for retrieving systematic reviews; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
Population: | ||
1. | Family practice[mh:noexp] OR Family physicians[mh:noexp] OR Community health services[mh:noexp] OR Primary care[tiab] OR General practi*[tiab] OR Primary health*[tiab] OR Community health*[tiab] OR Family practic*[tiab] OR Family medicine[tiab] OR Family physician*[tiab] | 289 570 |
Intervention: | ||
2. | "Ultrasonography"[Mesh] OR "Diagnostic Imaging"[Mesh] | 2 562 988 |
3. | ultraso*[Title/Abstract] OR sonogra*[Title/Abstract] | 390 301 |
4. | diagnos*[Title/Abstract] AND (screen*[Title/Abstract] OR scan*[Title/Abstract] OR imag*[Title/Abstract]) | 477 486 |
5. | "Point-of-Care Testing"[Mesh] OR "Point-of-Care Systems"[Mesh] | 13 267 |
6. | "point-of-care"[Title/Abstract] OR "point of care"[Title/Abstract] | 18 130 |
7. | pocus[Title/Abstract] OR "poc us"[Title/Abstract] OR "poc usg"[Title/Abstract] | 564 |
8. | portable[Title/Abstract] OR handheld[Title/Abstract] OR hand-held[Title/Abstract] OR mobile[Title/Abstract] OR bedside[Title/Abstract] | 155 763 |
9. | 2 OR 3 OR 4 | 2 956 491 |
10. | 5 OR 6 OR 7 OR 8 | 174 016 |
11. | 9 AND 10 | 25 526 |
Final | 1 AND 11 | 543 |
Search terms | Items found | |
The search result, usually found at the end of the documentation, forms the list of abstracts.; au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
Population: | ||
1. | MeSH descriptor: [Family Practice] explode all trees | 1 968 |
2. | MeSH descriptor: [Physicians, Family] explode all trees | 445 |
3. | MeSH descriptor: [Community Health Services] explode all trees | 12 948 |
4. | Primary care OR General practi* OR Primary health* OR Community health* OR Family practic* OR Family medicine OR Family physician*:ti,ab,kw | 183 741 |
5. | 15 OR 16 OR 17 OR 18 | 189 823 |
Intervention: | ||
6. | MeSH descriptor: [Ultrasonography] explode all trees | 13 513 |
7. | MeSH descriptor: [Diagnostic Imaging] explode all trees | 47 308 |
8. | 1 or 2 | 47 308 |
9. | ultraso* OR sonogra*:ti,ab,kw | 41 492 |
10. | diagnos* AND (screen* OR scan* OR imag*):ti,ab,kw | 67 926 |
11. | MeSH descriptor: [Point-of-Care Systems] explode all trees | 459 |
12. | MeSH descriptor: [Point-of-Care Testing] explode all trees | 58 |
13. | 6 OR 7 | 459 |
14. | "point-of-care" OR "point of care":ti,ab,kw | 1 974 |
15. | pocus OR "poc us" OR "poc usg":ti,ab,kw | 63 |
16. | portable OR handheld OR hand-held OR mobile OR bedside:ti,ab,kw | 14 627 |
17. | 8 OR 9 OR 10 | 114 364 |
18. | 13 OR 14 OR 15 OR 16 | 16 237 |
19. | 17 AND 18 | 2 246 |
Final | 5 AND 19 Cochrane reviews: 277 Cochrane protocols: 19 Trials: 616 Editorials: 0 Special Collections: 1 Clinical Answers: 2 |
915 |
Search terms | Items found | |
/de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
Population: | ||
1. | 'general practice'/exp OR 'general practitioner'/exp OR 'community care'/exp OR 'primary medical care'/exp | 360 883 |
2. | 'primary care' OR 'general practi*' OR 'primary health*' OR 'community health*' OR 'family practic*' OR 'family medicine' OR 'family physician*':ti,ab,kw | 637 736 |
3. | 1 OR 2 | 418 988 |
Intervention: | ||
4. | 'echography'/exp OR 'diagnostic imaging'/exp | 933 802 |
5. | ultraso* OR sonogra*:ti,ab,kw | 674 628 |
6. | diagnos*:ti,ab,kw AND (screen*:ti,ab,kw OR scan*:ti,ab,kw OR imag*:ti,ab,kw) | 756 403 |
7. | 4 OR 5 OR 6 | 1 810 852 |
8. | 'point of care system'/exp OR 'point of care testing'/exp | 13 912 |
9. | 'point-of-care' OR 'point of care':ti,ab,kw | 31 560 |
10. | pocus OR 'poc us' OR 'poc usg':ti,ab,kw | 1 017 |
11. | portable OR handheld OR 'hand held' OR mobile OR bedside:ti,ab,kw | 236 136 |
12. | 8 OR 9 OR 10 OR 11 | 261 293 |
Combined sets: | ||
13. | 7 AND 12 (intervention) | 31 085 |
14. | 3 AND 13 (population AND intervention) | 1 358 |
Study types: | ||
15. | 'systematic review'/exp OR 'meta analysis'/exp | 309 962 |
16. | systematic* AND review* OR 'meta-analysis' OR 'meta analysis':ti,ab,kw | 499 438 |
17. | 15 OR 16 | 499 438 |
18. | 'randomized controlled trial'/exp OR 'randomization'/exp OR 'controlled study'/exp | 7 166 074 |
19. | randomized OR randomised OR randomly OR random OR controlled:ti,ab,kw | 2 153 818 |
20. | 18 OR 19 | 8 262 186 |
21. | 'limit of detection'/exp OR 'sensitivity and specificity'/exp OR 'receiver operating characteristic'/exp OR 'predictive value'/exp OR 'reproducibility'/exp | 723 516 |
22. | (sensitiv* OR specific* OR 'limit of detection' OR 'predictive value' OR 'predictive values' OR reproduc* OR 'likelihood ratio' OR 'likelihood ratios' OR reliab* OR 're test' OR retest OR 'test retest' OR 'test re test' OR receiver) AND operating AND characteristic* OR (roc:ti,ab,kw AND (analy*:ti,ab,kw OR curve:ti,ab,kw OR curves*:ti,ab,kw)) | 161 604 |
23. | 21 OR 22 | 751 995 |
24. | 20 OR 23 | 8 766 917 |
Final | 14 AND 17 (systematic reviews) 14 AND 24 (primary studies) |
60 548 |
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