Pocket-sized echocardiography for screening structural heart disease: diagnostic accuracy and cost-effectiveness for population-based studies
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Updated: Dec 16, 2025
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Published on: August 9, 2024
Avisa Tabib1, Niloufar Samiei1, Mohammad M Peighambari1
1Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Insights
Pocket-sized echocardiography shows good agreement with standard methods for detecting heart conditions in children. This portable ultrasound can serve as a cost-effective screening tool for school-aged populations.
Area of Science:
- Pediatric Cardiology
- Medical Imaging
- Point-of-Care Ultrasound
Background:
- Standard transthoracic echocardiography has limitations in emergent and community settings.
- Pocket-sized ultrasound devices offer advancements in cardiac imaging accessibility.
Purpose of the Study:
- To evaluate the diagnostic accuracy and cost-effectiveness of pocket-sized echocardiography compared to standard echocardiography in children.
- To assess the utility of pocket-sized echocardiography as a screening tool in a school-based population.
Main Methods:
- Prospective study with hospital-based and school-based cohorts.
- Comparison of standard and pocket-sized echocardiography by experienced operators.
- Inclusion of children with suspected structural heart diseases and randomly selected healthy children.
Main Results:
- Good to excellent agreement between pocket-sized and standard echocardiography for major congenital heart diseases (CHDs).
- Moderate to excellent agreement for valvular pathologies, with higher agreement in the hospital-based cohort.
- Pocket-sized echocardiography demonstrated high sensitivity and specificity, with a significant cost reduction of approximately 70%.
Conclusions:
- Pocket-sized echocardiography, when used by experienced operators, is a viable screening tool for school-aged children.
- The technology offers a cost-effective and accessible alternative for cardiac assessment in community settings.
Background:
The standard transthoracic echocardiography has some limitations in emergent and community-based situations. The emergence of pocket-sized ultrasound has led to influential advancements.
Methods:
In this prospective study, in the hospital-based phase, children with suspected structural heart diseases were enrolled. In the school-based phase, healthy children were randomly selected from six schools. All individuals were examined by experienced operators using both the standard and the pocket-sized echocardiography.
Results:
A total of 73 individuals with a mean age of 9.9 ± 3.2 years in the hospital-based cohort and 143 individuals with a mean age of 12.8 ± 2.9 years in the school-based cohort were examined. The agreements between the standard and the pocket-sized echocardiography were good or excellent for major CHDs in both cohorts (κ statistics > 0.61). Among valvular pathologies, agreements for tricuspid and pulmonary valves' regurgitation were moderate among school-based cohorts (0.56 [95% confidence interval 0.12-1] and 0.6 [95% confidence interval 0.28-0.91], respectively). The agreements for tricuspid and pulmonary valves' regurgitation were excellent (>0.9) among hospital-based population. Other values for valvular findings were good or excellent. The overall sensitivity and specificity were 87.5% (95% confidence interval 47.3-99.7) and 93.8% (95% confidence interval 85-98.3) among the hospital-based individuals, respectively, and those were 88% (95% confidence interval 77.8-94.7) and 68.4% (95% confidence interval 56.7-78.6) among the school-based individuals, respectively. The cost of examination was reduced by approximately 70% for an individual using the pocket-sized device.
Conclusions:
When interpreted by experienced operators, the pocket-sized echocardiography can be used as screening tool among school-aged population.
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