Point-of-Care Ultrasound Use, Accuracy, and Impact on Clinical Decision Making in Rwanda Hospitals.

Objectives: Few studies of point‐of‐care ultrasound training and use in low resource settings have reported the impact of examinations on clinical management or the longer‐term quality of trainee‐performed studies. We characterized the long‐term effect of a point‐of‐care ultrasound program on clinical decision making, and evaluated the quality of clinician‐performed ultrasound studies. Methods: We conducted point‐of‐care ultrasound training for physicians from Rwandan hospitals. Physicians then used point‐of‐care ultrasound and recorded their findings, interpretation, and effects on patient management. Data were collected for 6 months. Trainee studies were reviewed for image quality and accuracy. Results: Fifteen participants documented 1158 ultrasounds; 590 studies (50.9%) had matched images and interpretations for review. Abdominal ultrasound for free fluid was the most frequently performed application. The mean image quality score was 2.36 (95% confidence interval, 2.28–2.44). Overall sensitivity and specificity for trainee‐performed examinations was 94 and 98%. Point‐of‐care ultrasound use most commonly changed medications administered (42.4%) and disposition (30%). Conclusions: A point‐of‐care ultrasound training intervention in a low‐resource setting resulted in high numbers of diagnostic‐quality studies over long‐term follow‐up. Ultrasound use routinely changed clinical decision making. [ABSTRACT FROM AUTHOR]