Accuracy and variability of nurses' focused ultrasound analysis. v1
Research type
Research Study
Full title
Focused cardiac ultrasound analysis by community nurses- a test of accuracy and variability.
IRAS ID
304785
Contact name
Emma Rees
Contact email
Sponsor organisation
Swansea University
Duration of Study in the UK
0 years, 1 months, 1 days
Research summary
Heart failure (HF) prevalence is increasing, particularly in the elderly. Earlier diagnosis enables earlier treatment which can improve patient outcomes. However, making a diagnosis at the point of presentation can be difficult because clinical examination and first-line tests lack accuracy for differentiating between causes of breathlessness. Delays in diagnosis often result in more appointments and additional costs.
New hand-held ultrasound machines offer the prospect of providing a more accurate ‘triage’ test at the point-of-care. We believe adding point-of-care ultrasound (POCUS) to the clinical assessment of elderly, breathless community could offer more efficient healthcare for those with suspected HF. However, current literature relating to POCUS use by nurses has focused on hospital and outpatient settings, not community settings. In a future study we hope to rigorously assess whether nurse-led POCUS in the community improves diagnostic accuracy and patient management. This initial proof-of-concept diagnostic accuracy and reproducibility study aims to assess the accuracy and variability of community nurse interpretation of left ventricular (LV) systolic function and volume status. We have already recruited a team of four senior nurses from a local acute clinical team. The nurses have attended a five-day POCUS training workshop and consolidating practice period. This study requires them to review 14 previously acquired (anonymised) focused ultrasound cases (blind to clinical information) on a computer at their clinical base. They will complete a standardised analysis form for each case (index test). Reference test comprises of the comprehensive echocardiogram report. Nurses will undertake repeated case interpretation two-weeks later and inter- and intra-variability will be assessed. Sensitivity and specificity to detect, primarily LV systolic dysfunction, will be calculated (target ≥0.8) and a repeated test agreement of >0.7 (Cohen’s Kappa) sought.
REC name
N/A
REC reference
N/A