Pocket-size imaging device: effectiveness for ward-based transthoracic studies

Aims Pocket-size imaging devices (PSID) are now available; their potential role in a hospital environment has been investigated but still remains undefined. Methods and results We evaluated the effectiveness of PSID in 92 patients referred for bedside transthoracic echocardiogram (TTE). Patients were included where there was a focused clinical question: quantification of left ventricular function (LVF); presence of regional wall motion abnormalities (RWMA); evidence of pericardial effusion, exclusion of significant valve pathology. Each patient underwent an echocardiography evaluation using PSID and TTE. In 83 patients [ k = 90%, 95% CI (82.2–95.4)], it was possible to answer the clinical question by PSID examination alone. There was agreement between the findings of PSID and TTE in 86 cases [79%; k = 47%, 95% CI (12.8–82.0)], in three cases, the clinical question was not answered by both modalities. When the clinical question was focused on LVF, the agreement was excellent [ k = 96%, 95% CI (95.3–97.9)], as was the agreement in the detection of RWMA [ k = 94.57%, 95% CI (82.4–95.1)]. There was also good concordance in the detection of valve pathology and pericardial effusion. Using PSID, the reduction in the scanning and reporting time was 66%. The cost-effectiveness analysis produced very favourable results: with PSE, we obtained an overall cost saving per scan of 76%, compared with TTE. Conclusion This study demonstrates that PSID can provide a valuable alternative to TTE in the presence of focused clinical questions and can provide an efficient way of delivering a ward-based transthoracic echo service.