Child Health Evaluative Sciences Program, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Haemophilia. 2020 Jul;26(4):685-693. doi: 10.1111/hae.14006. Epub 2020 May 22.
The objective of this survey was to understand the global trends of imaging assessments in persons with haemophilia, focusing on point-of-care ultrasound (POCUS). Insights into the barriers impeding its widespread proliferation as a frontline imaging modality were obtained.
The survey opened in September of 2017 and closed in May of 2018. Haemophilia Treatment Centres (HTCs) treating both paediatric/adult patients were the population of interest. A REDCap survey of 25 questions was disseminated to 232 clinical staff in 26 countries.
The majority of respondents (88.3%, 91/103) reported that POCUS is most useful to confirm or rule out a presumed acute joint bleed. European HTCs reported the highest routine use of POCUS at 59.5% (22/37) followed by HTCs in the "Other" countries of the world at 46.7% (7/15) and North American HTCs at 43.9% (25/57). At the time of the survey, physiotherapists were identified as the clinical staff who perform POCUS 52.8% (28/53) of the time, in contrast with nurses/nurse practitioners who represent only 5.7% (3/53) of users. The greatest perceived barriers to the implementation of POCUS are the lack of trained healthcare professionals who can perform POCUS at 69.2% (74/107) and the overall time commitment required at 68.2% (73/107).
Despite POCUS being used in 49.5% (54/109) of sampled HTCs, it is still utilized almost 30% less globally than full diagnostic ultrasound. A list of barriers has been identified to inform HTCs which challenges they will likely need to overcome should they choose to incorporate this imaging modality into their practice.
本研究旨在了解全球血友病患者影像学评估的趋势，重点关注即时护理超声（POCUS）。我们深入了解了阻碍其作为一线影像学手段广泛普及的障碍。
该研究于 2017 年 9 月开始，2018 年 5 月结束。研究对象为治疗儿童/成人患者的血友病治疗中心（HTCs）。我们向 26 个国家的 232 名临床工作人员发放了包含 25 个问题的 REDCap 调查。
大多数受访者（88.3%，91/103）报告称，POCUS 最常用于确认或排除疑似急性关节出血。欧洲 HTCs 报告称，POCUS 的常规使用率最高，为 59.5%（22/37），其次是世界上其他国家的 HTCs，为 46.7%（7/15），北美 HTCs 为 43.9%（25/57）。在调查时，物理治疗师被认为是进行 POCUS 的临床工作人员，他们进行 POCUS 的时间占 52.8%（28/53），而护士/执业护士的使用率仅为 5.7%（3/53）。实施 POCUS 的最大障碍是缺乏能够进行 POCUS 的训练有素的医疗保健专业人员，占 69.2%（74/107），以及总体所需的时间承诺，占 68.2%（73/107）。
尽管 49.5%（54/109）的 HTCs 中使用了 POCUS，但与全诊断超声相比，它在全球的使用率仍低 30%左右。已经确定了一系列障碍，以便告知 HTCs，如果他们选择将这种影像学手段纳入他们的实践，他们可能需要克服哪些挑战。
