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ABSTRACT: Background
Echocardiographic screening can detect asymptomatic cases of rheumatic heart disease (RHD), facilitating access to treatment. Barriers to implementation of echocardiographic screening include the requirement for expensive equipment and expert practitioners. We aimed to evaluate the diagnostic accuracy of an abbreviated echocardiographic screening protocol (single parasternal-long-axis view with a sweep of the heart) performed by briefly trained, nonexpert practitioners using handheld ultrasound devices.Methods
Participants aged 5 to 20 years in Timor-Leste and the Northern Territory of Australia had 2 echocardiograms: one performed by an expert echocardiographer using a GE Vivid I or Vivid Q portable ultrasound device (reference test), and one performed by a nonexpert practitioner using a GE Vscan handheld ultrasound device (index test). The accuracy of the index test, compared with the reference test, for identifying cases with definite or borderline RHD was determined.Results
There were 3111 enrolled participants; 2573 had both an index test and reference test. Median age was 12 years (interquartile range, 10-15); 58.2% were female. Proportion with definite or borderline RHD was 5.52% (95% CI, 4.70-6.47); proportion with definite RHD was 3.23% (95% CI, 2.61-3.98). Compared with the reference test, sensitivity of the index test for definite or borderline RHD was 70.4% (95% CI, 62.2-77.8), specificity was 78.1% (95% CI, 76.4-79.8).Conclusions
Nonexpert practitioners can be trained to perform single parasternal-long-axis view with a sweep of the heart echocardiography. However, the specificity and sensitivity are inadequate for echocardiographic screening. Improved training for nonexpert practitioners should be investigated.
SUBMITTER: Francis JR
PROVIDER: S-EPMC8373443 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
Francis Joshua R JR Whalley Gillian A GA Kaethner Alex A Fairhurst Helen H Hardefeldt Hilary H Reeves Benjamin B Auld Benjamin B Marangou James J Horton Ari A Wheaton Gavin G Robertson Terry T Ryan Chelsea C Brown Shannon S Smith Greg G Dos Santos Januario J Flavio Ricardo R Embaum Karolina K da Graca Noronha Mario M Lopes Belo Sonia S Madeira Santos Carla C Georginha Dos Santos Maria M Cabral Jose J do Rosario Ivonia I Harries Jessica J Francis Laura A LA Draper Anthony D K ADK James Christian L CL Davis Kimberly K Yan Jennifer J Mitchell Alice A da Silva Almeida Ines I Engelman Daniel D Roberts Kathryn V KV Ralph Anna P AP Remenyi Bo B
Circulation. Cardiovascular imaging 20210813 8
<h4>Background</h4>Echocardiographic screening can detect asymptomatic cases of rheumatic heart disease (RHD), facilitating access to treatment. Barriers to implementation of echocardiographic screening include the requirement for expensive equipment and expert practitioners. We aimed to evaluate the diagnostic accuracy of an abbreviated echocardiographic screening protocol (single parasternal-long-axis view with a sweep of the heart) performed by briefly trained, nonexpert practitioners using h ...[more]