Can clinicians quantify pulmonary congestion accurately using conventional modalities without remote dielectric...

Accurate assessment of pulmonary congestion is essential for managing heart failure but remains challenging using conventional clinical methods. The Remote Dielectric Sensing (ReDS) system provides a non-invasive, objective measurement of lung fluid content. However, its high cost raises the question of whether clinicians can estimate congestion with similar accuracy without referencing such a technology. In this prospective study, 26 hospitalized patients with cardiovascular disease underwent ReDS measurement. A total of 112 ReDS value estimations were obtained from junior and senior clinicians, who were blinded to the actual values and estimated lung fluid content using routine clinical data. Estimation accuracy was evaluated using correlation analysis, Bland-Altman plots, and subgroup comparisons based on ReDS severity and clinician experience. Estimated and measured ReDS values showed a moderate correlation (R = 0.70, p < 0.001). However, more than 50% of estimations exhibited discrepancies of ≥  ± 3%, particularly in cases of mild congestion. Underestimation occurred in over 60% of cases and was more pronounced among senior clinicians. A regression formula incorporating estimated ReDS and B-type natriuretic peptide improved prediction accuracy (R = 0.78, p < 0.001). Clinicians frequently underestimate pulmonary congestion, especially when it is mild. This may lead to suboptimal diuretic management. The ReDS system can serve as a valuable adjunct to conventional assessment, particularly in less overt cases, and may enhance both diagnostic precision and therapeutic decision-making.