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Real-Time Tele-Mentored Low Cost "Point-of-Care US" in the Hands of Paediatricians in the Emergency Department: Diagnostic Accuracy Compared to Expert Radiologists

Zennaro, Floriana ; Neri, Elena ; Nappi, Federico ; Grosso, Daniele ; Triunfo, Riccardo ; Cabras, Francesco ; Frexia, Francesca ; Norbedo, Stefania ; Guastalla, Pierpaolo ; Gregori, Massino ; Cattaruzzi, Elisabetta ; Sanabor, Daniela ; Barbi, Egidio ; Lazzerini, Marzia Floto, Andres R.

PloS one, 2016-10, Vol.11 (10), p.e0164539-e0164539 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Real-Time Tele-Mentored Low Cost "Point-of-Care US" in the Hands of Paediatricians in the Emergency Department: Diagnostic Accuracy Compared to Expert Radiologists
Autor: Zennaro, Floriana ; Neri, Elena ; Nappi, Federico ; Grosso, Daniele ; Triunfo, Riccardo ; Cabras, Francesco ; Frexia, Francesca ; Norbedo, Stefania ; Guastalla, Pierpaolo ; Gregori, Massino ; Cattaruzzi, Elisabetta ; Sanabor, Daniela ; Barbi, Egidio ; Lazzerini, Marzia
Floto, Andres R.
Assuntos: Abdomen ; Abdomen - diagnostic imaging ; Accuracy ; Adolescent ; Appendicitis ; Child ; Child, Preschool ; Children ; Children & youth ; Childrens health ; Commercial off-the-shelf technology ; Comparative analysis ; Computer Systems ; Cost control ; Diagnostic Errors - statistics & numerical data ; Diagnostic systems ; Economic aspects ; Emergency medical care ; Emergency medical services ; Emergency Service, Hospital - economics ; Engineering and Technology ; Equipment costs ; Feasibility studies ; Female ; Hospital emergency services ; Humans ; Infant ; Infant, Newborn ; Low cost ; Male ; Maternal & child health ; Medical diagnosis ; Medical imaging ; Medicine ; Medicine and Health Sciences ; Open source software ; Pain ; Pediatricians ; Pediatrics ; People and Places ; Physicians ; Point-of-Care Systems ; Professional Practice - statistics & numerical data ; Radiology ; Remote Consultation - instrumentation ; Remote Consultation - methods ; Research and Analysis Methods ; Software ; Source code ; Telemedicine ; Ultrasonic imaging ; Ultrasonography ; Ultrasound ; Ultrasound imaging
É parte de: PloS one, 2016-10, Vol.11 (10), p.e0164539-e0164539
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Conceptualization: FZ EN ML.Data curation: FZ EN FN.Formal analysis: EN FN ML.Funding acquisition: FZ.Methodology: FZ EN ML.Resources: FZ PG ML.Software: DG RT FC FF.Supervision: FZ EB ML.Validation: FZ DG RT FC FF.Visualization: FZ ML.Writing – original draft: ML.Writing – review & editing: FZ EN FN DG RT FC FF SN PG MG EC DS EB ML.
Competing Interests: The authors have declared that no competing interests exist.
Descrição: The use of point-of-care ultrasonography (POC US) in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED) when performed by paediatricians under the remote guidance of radiologists (TELE POC). Children aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC); by the same radiologist (UNBLIND RAD); by an independent blinded radiologist (BLIND RAD). Tele-radiology was implemented using low cost "commercial off-the-shelf" (COTS) equipment and open-source software. Data were prospectively collected on predefined templates. Fifty-two children were enrolled, for a total of 170 ultrasound findings. Sensitivity, specificity, positive and negative predictive values of TELE POC were: 93.8, 99.7, 96.8, 99.4 when compared to UNBLIND RAD and 88.2, 99.7, 96.8, 98.7 when compared to BLIND RAD. The inter-observers agreement between the paediatricians and either the unblind or blind radiologist was excellent (k = 0.93). The mean duration of TELE POC was 6.3 minutes (95% CI 4.1 to 8.5). Technical difficulties occurred in two (3.8%) cases. Quality of the transmission was rated as fair, good, very good and excellent in 7.7%, 15.4%, 42.3% and 34.6% of cases respectively, while in no case was it rated as poor. POC US performed by paediatricians in ED guided via tele-radiology by an expert radiologist (TELE POC) produced reliable and timely diagnoses. Findings of this study, especially for the rarer conditions under evaluation, need further confirmation. Future research should investigate the overall benefits and the cost savings of using tele-ultrasound to perform US "at children's bedsides", under remote guidance of expert radiologists.
Editor: United States: Public Library of Science
Idioma: Inglês

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Real-Time Tele-Mentored Low Cost "Point-of-Care US" in the Hands of Paediatricians in the Emergency Department: Diagnostic Accuracy Compared to Expert Radiologists

Zennaro, Floriana ; Neri, Elena ; Nappi, Federico ; Grosso, Daniele ; Triunfo, Riccardo ; Cabras, Francesco ; Frexia, Francesca ; Norbedo, Stefania ; Guastalla, Pierpaolo ; Gregori, Massino ; Cattaruzzi, Elisabetta ; Sanabor, Daniela ; Barbi, Egidio ; Lazzerini, Marzia Floto, Andres R.

United States: Public Library of Science

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