Galusko Victor, Bodger Owen, Ionescu Adrian
Swansea University Medical School, Swansea University, Singleton Park, Swansea, UK.
Morriston Cardiac Regional Centre, ABMU LHB, Swansea, UK.
Echo Res Pract. 2018 Dec 1;5(4):113-138. doi: 10.1530/ERP-18-0030.
Hand-held imaging devices are widely used in clinical practice and are a useful tool. There is no published review examining the diagnostic parameters achieved with these devices in clinical practice.
We searched three online medical literature databases (PubMed, EMBASE and MEDLINE) for all literature published up until January 2018. We selected studies that (1) were conducted in the adult population; (2) used a truly hand-held device; (3) featured sensitivities and/or specificities on the use of the hand-held scanner. We extracted and summarised the diagnostic metrics from the literature.
Twenty-seven articles were excluded from the initial 56 relevant articles, as the device featured was not truly hand-held. Ultimately a total of 25 studies were analysed. Sixteen studies were carried out by experienced users, seven by users with little previous experience and two studies by nurses. High diagnostic parameters were achieved by all three groups when scanning cardiac pathology and intra-abdominal structures. Training of non-expert users varied, taking a mean of 21.6 h. These hand-held devices can change diagnoses at the bedside and be used as gate-keepers to formal echocardiography. Individual studies show them to be cost-effective.
Hand-held echocardiography is a useful tool in the hands of experts and novices alike. Studies conducted are highly heterogeneous making it difficult to pool data for the diagnostic metrics. Further studies with rigorous methodology are needed to evaluate the true diagnostic potential in the hands of non-experts and in the community as well as to validate training protocols.
手持式成像设备在临床实践中被广泛使用，是一种有用的工具。目前尚无已发表的综述探讨这些设备在临床实践中所达到的诊断参数。
我们检索了三个在线医学文献数据库（PubMed、EMBASE和MEDLINE），以查找截至2018年1月发表的所有文献。我们选择的研究需满足以下条件：（1）在成年人群中进行；（2）使用真正的手持式设备；（3）具有手持式扫描仪使用的敏感性和/或特异性。我们从文献中提取并总结了诊断指标。
最初的56篇相关文章中有27篇被排除，因为所介绍的设备并非真正的手持式设备。最终共分析了25项研究。16项研究由经验丰富的使用者进行，7项由之前经验较少的使用者进行，2项研究由护士进行。在扫描心脏病理和腹内结构时，所有三组均获得了较高的诊断参数。非专家使用者的培训方式各不相同，平均耗时21.6小时。这些手持式设备可在床边改变诊断结果，并用作正式超声心动图检查的把关手段。个别研究表明它们具有成本效益。
手持式超声心动图对专家和新手来说都是一种有用的工具。所开展的研究具有高度异质性，难以汇总诊断指标的数据。需要采用严格方法进行进一步研究，以评估非专家以及社区环境中其真正的诊断潜力，并验证培训方案。
