1
|
Ovesen SH, Clausen AH, Kirkegaard H, Løfgren B, Aagaard R, Skaarup SH, Arvig MD, Lorentzen MH, Kristensen AH, Cartuliares MB, Falster C, Tong L, Rabajoli A, Leth R, Desy J, Ma IWY, Weile J. Point-of-Care Lung Ultrasound in Emergency Medicine: A Scoping Review With an Interactive Database. Chest 2024; 166:544-560. [PMID: 38458431 DOI: 10.1016/j.chest.2024.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND This scoping review was conducted to provide an overview of the evidence of point-of-care lung ultrasound (LUS) in emergency medicine. By emphasizing clinical topics, time trends, study designs, and the scope of the primary outcomes, a map is provided for physicians and researchers to guide their future initiatives. RESEARCH QUESTION Which study designs and primary outcomes are reported in published studies of LUS in emergency medicine? STUDY DESIGN AND METHODS We performed a systematic search in the PubMed/MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library databases for LUS studies published prior to May 13, 2023. Study characteristics were synthesized quantitatively. The primary outcomes in all papers were categorized into the hierarchical Fryback and Thornbury levels. RESULTS A total of 4,076 papers were screened and, following selection and handsearching, 406 papers were included. The number of publications doubled from January 2020 to May 2023 (204 to 406 papers). The study designs were primarily observational (n = 375 [92%]), followed by randomized (n = 18 [4%]) and case series (n = 13 [3%]). The primary outcome measure concerned diagnostic accuracy in 319 papers (79%), diagnostic thinking in 32 (8%), therapeutic changes in 4 (1%), and patient outcomes in 14 (3%). No increase in the proportions of randomized controlled trials or the scope of primary outcome measures was observed with time. A freely available interactive database was created to enable readers to search for any given interest (https://public.tableau.com/app/profile/blinded/viz/LUSinEM_240216/INFO). INTERPRETATION Observational diagnostic studies have been produced in abundance, leaving a paucity of research exploring clinical utility. Notably, research exploring whether LUS causes changes to clinical decisions is imperative prior to any further research being made into patient benefits.
Collapse
Affiliation(s)
- Stig Holm Ovesen
- Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Emergency Department, Horsens Regional Hospital, Horsens, Denmark.
| | | | - Hans Kirkegaard
- Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Bo Løfgren
- Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark
| | - Rasmus Aagaard
- Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark
| | - Søren Helbo Skaarup
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Dan Arvig
- Department of Emergency Medicine, Slagelse Hospital, Slagelse, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Morten Hjarnø Lorentzen
- Department of Emergency Medicine, Hospital Sønderjylland, Aabenraa, Denmark; Department of Regional Health Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Anne Heltborg Kristensen
- Department of Emergency Medicine, Hospital Sønderjylland, Aabenraa, Denmark; Department of Regional Health Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Mariana Bichuette Cartuliares
- Department of Emergency Medicine, Hospital Sønderjylland, Aabenraa, Denmark; Department of Regional Health Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Casper Falster
- Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark; Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Liting Tong
- Emergency Department, Nykøbing F. Hospital, Zealand Denmark Region, Denmark
| | - Alessandra Rabajoli
- Division of Emergency Medicine and High Dependency Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Ronja Leth
- Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Emergency Department, Horsens Regional Hospital, Horsens, Denmark
| | - Janeve Desy
- Division of General Internal Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Office of Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Irene W Y Ma
- Division of General Internal Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jesper Weile
- Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Emergency Department, Horsens Regional Hospital, Horsens, Denmark
| |
Collapse
|
2
|
Innocenti T, Ostelo R, Verhagen A, Pinto RZ, Salvioli S, Giagio S, Chiarotto A. Rehabilitation journal editors recognize the need for interventions targeted to improve the completeness of reporting, but there is heterogeneity in terms of strategies actually adopted: A cross-sectional web-based survey. J Evid Based Med 2023. [PMID: 36992559 DOI: 10.1111/jebm.12527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023]
Affiliation(s)
- Tiziano Innocenti
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Movement Sciences, Amsterdam, Netherlands
- GIMBE Foundation, Bologna, Italy
| | - Raymond Ostelo
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Movement Sciences, Amsterdam, Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC, Movement Sciences Research Institute, Amsterdam, Netherlands
| | - Arianne Verhagen
- Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Rafael Zambelli Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Stefano Salvioli
- GIMBE Foundation, Bologna, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Silvia Giagio
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Alessandro Chiarotto
- Faculty of Science, Department of Health Sciences, Vrije Universiteit Amsterdam, Movement Sciences, Amsterdam, Netherlands
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| |
Collapse
|
3
|
Naaman K, Grant S, Kianersi S, Supplee L, Henschel B, Mayo-Wilson E. Exploring enablers and barriers to implementing the Transparency and Openness Promotion Guidelines: a theory-based survey of journal editors. ROYAL SOCIETY OPEN SCIENCE 2023; 10:221093. [PMID: 36756061 PMCID: PMC9890101 DOI: 10.1098/rsos.221093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/09/2023] [Indexed: 05/27/2023]
Abstract
The Transparency and Openness Promotion (TOP) Guidelines provide a framework to help journals develop open science policies. Theories of behaviour change can guide understanding of why journals do (not) implement open science policies and the development of interventions to improve these policies. In this study, we used the Theoretical Domains Framework to survey 88 journal editors on their capability, opportunity and motivation to implement TOP. Likert-scale questions assessed editor support for TOP, and enablers and barriers to implementing TOP. A qualitative question asked editors to provide reflections on their ratings. Most participating editors supported adopting TOP at their journal (71%) and perceived other editors in their discipline to support adopting TOP (57%). Most editors (93%) agreed their roles include maintaining policies that reflect current best practices. However, most editors (74%) did not see implementing TOP as a high priority compared with other editorial responsibilities. Qualitative responses expressed structural barriers to implementing TOP (e.g. lack of time, resources and authority to implement changes) and varying support for TOP depending on study type, open science standard, and level of implementation. We discuss how these findings could inform the development of theoretically guided interventions to increase open science policies, procedures and practices.
Collapse
Affiliation(s)
- Kevin Naaman
- School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
- School of Education, Indiana University-Bloomington, Bloomington, IN, USA
| | - Sean Grant
- HEDCO Institute for Evidence-Based Educational Practice, University of Oregon, Eugene, OR, USA
- Richard M. Fairbanks School of Public Health, Indiana University-Indianapolis, Indianapolis, IN, USA
| | - Sina Kianersi
- School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Beate Henschel
- School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
| | - Evan Mayo-Wilson
- School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
4
|
Prager R, Pageau P, Hodges T, Yan C, Woo M, Nemnom M, Millington S, Holden M, St‐Gelais R, Cheung WJ. Characterizing the biomechanical differences between novice and expert point-of-care ultrasound practitioners using a low-cost gyroscope and accelerometer integrated sensor: A pilot study. AEM EDUCATION AND TRAINING 2022; 6:e10733. [PMID: 35392491 PMCID: PMC8963729 DOI: 10.1002/aet2.10733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/20/2022] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
Introduction Point-of-care ultrasound (POCUS) has become an important diagnostic tool in acute care medicine; however, little is known about the biomechanical differences between novice and expert practitioners. Methods A low-cost ($50 CAD) gyroscope and accelerometer integrated sensor was assembled and affixed to an ultrasound probe. Seventeen participants, nine novices and eight experts, were recruited to perform three abdominal and four cardiac scans on a standardized patient. Participant demographics, time per scan, average acceleration, average angular velocity, decay in acceleration and angular velocity over time, and frequency of probe movements were analyzed. Video capture with blinded video review was scored. Results On video review, experts had higher image optimization and acquisition scores for both abdominal and cardiac scans. Experts had shorter scan times for abdominal (7 s vs. 26 s, p = 0.003) and cardiac (11 s vs. 26 s, p < 0.001) scans. There was no difference in average acceleration (g) between novices and experts performing abdominal (1.02 vs. 1.01, p = 0.50) and cardiac (1.01 vs. 1.01, p = 0.45) scans. Experts had lower angular velocity (°/s) for abdominal scans (10.00 vs. 18.73, p < 0.001) and cardiac scans (15.61 vs. 20.33, p = 0.02) There was a greater decay in acceleration over time for experts performing cardiac scans compared to novices (-0.194 vs. -0.050, p = 0.03) but not for abdominal scans or when measuring angular velocity. The frequency of movements (Hz) was higher for novices compared to experts for abdominal (16.68 vs. 13.79, p < 0.001) and cardiac (17.60 vs. 13.63, p = 0.002) scans. Discussion This study supports the feasibility of a low-cost gyroscope and accelerometer integrated sensor to quantify the biomechanics of POCUS. It may also support the concept of "window shopping" as a method by which experts obtain abdominal and cardiac views, where sliding is used to find an acoustic window, then smaller rocking and tilting probe movements are used to refine the image.
Collapse
Affiliation(s)
- Ross Prager
- Department of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Paul Pageau
- Department of Emergency MedicineUniversity of OttawaOttawaOntarioCanada
| | - Timothy Hodges
- Faculty of EngineeringUniversity of OttawaOttawaOntarioCanada
| | - Christina Yan
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Michael Woo
- Department of Emergency MedicineUniversity of OttawaOttawaOntarioCanada
| | - Marie‐Joe Nemnom
- Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Scott Millington
- Division of Critical CareUniversity of OttawaOttawaOntarioCanada
| | - Matthew Holden
- School of Computer ScienceCarleton UniversityOttawaOntarioCanada
| | | | - Warren J. Cheung
- Department of Emergency MedicineUniversity of OttawaOttawaOntarioCanada
| |
Collapse
|
5
|
THE STRUCTURE FORMAT OF ABSTRACTS: A SURVEY OF LEADING DENTAL JOURNALS AND THEIR EDITORS. J Evid Based Dent Pract 2021; 22:101646. [DOI: 10.1016/j.jebdp.2021.101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/28/2021] [Accepted: 09/15/2021] [Indexed: 11/22/2022]
|
6
|
Le Goff B. US in the pocket: At last a stethoscope for the rheumatologists? Joint Bone Spine 2021; 89:105264. [PMID: 34506934 DOI: 10.1016/j.jbspin.2021.105264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Benoit Le Goff
- Service de rhumatologie, Hôtel-Dieu, 1, place Alexis Ricordeau, 44093 Nantes cedex 1, France.
| |
Collapse
|
7
|
Prager R, Pratte M, Guy A, Bala S, Bachar R, Kim DJ, Millington S, Salameh JP, McGrath TA, McInnes MD. Completeness of reporting for systematic reviews of point-of-care ultrasound: a meta-research study. BMJ Evid Based Med 2021; 26:bmjebm-2020-111652. [PMID: 33785511 DOI: 10.1136/bmjebm-2020-111652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Systematic reviews are often considered among the highest quality of evidence. Completely reported systematic reviews, however, are required so readers can assess for generalisability of the research to practice and risk of bias. The objective of this study was to assess the completeness of reporting for systematic reviews assessing the diagnostic accuracy of point-of-care ultrasound (POCUS) using the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Diagnostic Test Accuracy (PRISMA-DTA) checklist that was published in 2018. DESIGN AND SETTING In this meta-research study, MEDLINE, EMBASE and Cochrane Library databases were searched, with no date restriction, on March 1st, 2020 for systematic reviews assessing the diagnostic accuracy of POCUS. Adherence to PRISMA-DTA for the main text and abstract was scored independently and in duplicate using a modified checklist. Prespecified subgroup analyses were performed. MAIN OUTCOME MEASURES The primary outcome was the mean PRISMA-DTA checklist adherence for the full-text and abstract. RESULTS A total of 71 studies published from 2008 to 2020 met the inclusion criteria. The overall adherence for the full-text was moderate: 19.8 out of 26.0 items (76%) and for the abstract was 7.0 out of 11.0 items (64%). Although many items in the PRISMA-DTA checklist were frequently reported, several were r infrequently reported (<33% of studies), including item 5 (protocol registration), item D2 (minimally acceptable test accuracy) and item 14 (variability in target condition, index test and reference standards). Subgroup analyses showed a higher PRISMA-DTA mean adherence (SD) for high impact journals (20.9 (2.52) vs 18.9 (1.95); p<0.001), studies including supplemental materials (20.6 (2.48) vs 18.9 (2.28); p=0.004), studies citing adherence to PRISMA reporting guidelines (20.4 (1.95) vs 19.0 (3.00); p=0.038) and studies published in journals endorsing PRISMA guidelines (20.2 (2.47) vs 18.6 (2.37); p=0.025). There was variable adherence based on journal of publication (p=0.006), but not for study population (adult vs paediatric vs mixed) (p=0.62), year of publication (p=0.94), body region (p=0.78) or country (p=0.40). There was no variability in abstract adherence based on whether the abstract was structured with subheadings or not (p=0.25). A Spearman's correlation found moderate correlation between higher word counts and abstractand full-text adherence (R=0.45, p<0.001 and R=0.38, p=0.001), respectively. CONCLUSIONS Overall, the reporting of POCUS diagnostic accuracy systematic reviews and meta-analyses was moderate. We identified deficits in several key areas including the preregistration of systematic reviews in an online repository, handling of multiple definitions of target conditions, index tests and reference standards and specifying minimally acceptable test accuracy. Prospective registration of reviews and detailed reporting as per PRISMA-DTA during the research process could improve reporting completeness. At an editorial level, word count and supplemental material limitations may impede reporting completeness, whereas endorsement of reporting guidelines on journal websites could improve reporting.
Collapse
Affiliation(s)
- Ross Prager
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Michael Pratte
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew Guy
- Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sudarshan Bala
- Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Roudi Bachar
- Medicine-Surgery, Wrexham Maelor Hospital, Wrexham, UK
| | - Daniel J Kim
- Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Scott Millington
- Division of Critical Care, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Trevor A McGrath
- Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada
| | - Matthew Df McInnes
- Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada
- Department of Epidemiology, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|