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Accuracy of Resident-Performed Point-of-Care Lung Ultrasound Examinations Versus Chest Radiography in Pneumothorax Follow-up After Tube Thoracostomy in Rwanda.
Accuracy of Resident-Performed Point-of-Care Lung Ultrasound Examinations Versus Chest Radiography in Pneumothorax Follow-up After Tube Thoracostomy in Rwanda.
- Source :
-
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine [J Ultrasound Med] 2020 Mar; Vol. 39 (3), pp. 499-506. Date of Electronic Publication: 2019 Sep 06. - Publication Year :
- 2020
-
Abstract
- Objectives: The aim of this study was to evaluate the accuracy and timeliness of resident-performed point-of-care lung ultrasound (LUS) examinations for the follow-up of pneumothorax (PTX) after tube thoracostomy.<br />Methods: After brief training, Rwandan surgical residents blinded to chest radiography (CXR) performed and interpreted LUS examinations for PTX in participants undergoing CXR for PTX follow-up. Treating clinicians interpreted CXR for the presence of PTX for therapeutic decisions. Lung ultrasound was later reviewed by ultrasound experts, and CXR was reviewed by a radiologist. We defined expert LUS interpretation as the reference standard. The sensitivity and specificity of resident-performed LUS examinations for diagnosing PTX were calculated. We assessed agreement between trained resident versus expert LUS and clinician versus radiology CXR using the Cohen κ coefficient. We compared the time to results between LUS and CXR.<br />Results: Over an 8-month period, 51 participants were enrolled. Compared to expert LUS interpretation, the sensitivity and specificity (95% confidence intervals) of resident LUS were 100% (85%-100%) and 96% (82%-100%), respectively, whereas the sensitivity and specificity of clinician-interpreted CXR were 48% (27%-69%) and 100% (88%-100%). The agreement between resident and expert LUS was excellent (κ = 0.96), whereas the agreement between clinician and radiologist CXR was only moderate (κ = 0.60). The time to results was significantly longer for CXR than LUS (mean, 1335 versus 396 minutes; P = .0001).<br />Conclusions: A resident-performed LUS examination was a quicker imaging modality with superior sensitivity compared to clinician-interpreted CXR for PTX follow-up after tube thoracostomy in this Rwandan study. Lung ultrasound can be a valuable imaging tool for PTX follow-up, especially in resource-limited settings.<br /> (© 2019 by the American Institute of Ultrasound in Medicine.)
- Subjects :
- Adolescent
Adult
Child
Female
Follow-Up Studies
Humans
Lung diagnostic imaging
Male
Middle Aged
Postoperative Complications diagnostic imaging
Prospective Studies
Reproducibility of Results
Rwanda
Sensitivity and Specificity
Ultrasonography instrumentation
Young Adult
Clinical Competence statistics & numerical data
Internship and Residency statistics & numerical data
Pneumothorax diagnostic imaging
Point-of-Care Systems
Radiography, Thoracic methods
Thoracostomy adverse effects
Ultrasonography methods
Subjects
Details
- Language :
- English
- ISSN :
- 1550-9613
- Volume :
- 39
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 31490569
- Full Text :
- https://doi.org/10.1002/jum.15126