Volpicelli Giovanni, Rovida Serena
Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy.
Università degli Studi "Magna Graecia", Azienda Universitario-Ospedaliera "Dulbecco", Policlinico "Mater Domini" - Campus Universitario, Viale Europa, Germaneto, Catanzaro, 88100, Italia.
Ultrasound J. 2024 May 10;16(1):28. doi: 10.1186/s13089-024-00368-3.
Over the last 20 years, advances in point-of-care lung ultrasound (PoCLUS) have been consistent. The clinical application of PoCLUS has drastically changed the diagnosis of some respiratory conditions mainly in the acute setting. Despite these improvements, misconceptions regarding the current scientific evidence and errors in the direction given to the latest research are delaying the implementation of PoCLUS in the clinical field. The diagnostic power of PoCLUS is still under-evaluated in many settings and there is a generalized yet unjustified feeling that further evidence is needed before introducing PoCLUS as a standard of care. In the effort to build up further evidence by new studies, the role of randomized clinical trials is over-emphasized and gold standards used to investigate diagnostic accuracy of PoCLUS are sometimes not appropriate. Moreover, the sonographic patterns and techniques used to confirm the diagnoses not always are adapted to the patients' clinical condition, which limit the scientific value of those clinical studies. Finally, there is a recurrent confusion in the role of PoCLUS scoring techniques, which should be only applied to quantify and monitor injury severity and not to diagnose lung diseases. Awareness of these misconceptions and errors could help the researchers when approaching new study projects on PoCLUS.
在过去20年中，床旁肺部超声（PoCLUS）取得了持续进展。PoCLUS的临床应用极大地改变了某些呼吸系统疾病的诊断，主要是在急性情况下。尽管有这些进步，但关于当前科学证据的误解以及对最新研究指导方向的错误，正在延缓PoCLUS在临床领域的应用。PoCLUS的诊断能力在许多情况下仍未得到充分评估，并且存在一种普遍但不合理的看法，即在将PoCLUS作为护理标准引入之前，还需要更多证据。在通过新研究积累更多证据的努力中，随机临床试验的作用被过度强调，用于研究PoCLUS诊断准确性的金标准有时并不合适。此外，用于确诊的超声模式和技术并不总是适应患者的临床状况，这限制了这些临床研究的科学价值。最后，PoCLUS评分技术的作用经常存在混淆，该技术仅应用于量化和监测损伤严重程度，而不是用于诊断肺部疾病。认识到这些误解和错误，有助于研究人员开展关于PoCLUS的新研究项目。
