Clinical Influence of Handheld Ultrasound, Supported by Automatic Quantification and Telemedicine, in Suspected Heart...

Area of Science:

• Cardiology
• Medical Technology
• Primary Care

Background:

• Early and accurate heart failure (HF) diagnosis is crucial for effective patient management.
• General practitioners (GPs) play a key role in initial patient assessment.
• Integrating advanced diagnostic tools into primary care can potentially improve diagnostic capabilities.

Purpose of the Study:

• To assess the clinical impact of handheld ultrasound device (HUD) examinations by GPs in diagnosing suspected heart failure.
• To evaluate the added value of automatic measurements (left ventricular ejection fraction, mitral annular plane systolic excursion) and telemedical support.
• To compare diagnostic accuracy at different stages of GP assessment.

Main Methods:

• 166 patients with suspected HF were examined by five GPs with limited ultrasound experience.
• GPs performed clinical examination, followed by HUD examination with and without automatic quantification tools, and telemedical support.
• Final diagnosis was established by cardiologists using standard echocardiography and clinical evaluation.

Main Results:

• GPs' diagnostic accuracy increased from 54% (clinical evaluation) to 71% (with HUD) and 74% (with HUD and telemedicine).
• Net reclassification improvement was highest when combining HUD and telemedicine.
• Automatic measurement tools did not provide a significant benefit (p ≥ 0.58).

Conclusions:

• Handheld ultrasound devices combined with telemedical support significantly improve GPs' diagnostic precision in suspected heart failure.
• Automatic left ventricular quantification tools did not enhance diagnostic accuracy for inexperienced users.
• Further development of algorithms and training is needed for inexperienced users to benefit from automatic cardiac function quantification via HUDs.