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Poppleton A, Tsukagoshi S, Vinker S, Heritier F, Frappé P, Dupont F, Sigmund P, Iacob M, Vilaseca J, Ungan M, Aakjær Andersen C, Frese T, Halata D. World Organization of National Colleges, Academies and Academic Associations of General Practitioners and Family Physicians (WONCA) Europe position paper on the use of point-of-care ultrasound (POCUS) in primary care. Prim Health Care Res Dev 2024; 25:e21. [PMID: 38651341 PMCID: PMC11091537 DOI: 10.1017/s1463423624000112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/29/2023] [Accepted: 02/17/2024] [Indexed: 04/25/2024] Open
Affiliation(s)
| | | | | | | | - Paul Frappé
- Université Jean Monnet, Saint-Etienne, France
| | | | - Peter Sigmund
- Steirischen Akademie für Allgemeinmedizin, Graz, Austria
| | - Mihai Iacob
- Victor Babes University of Medicine and Pharmacy, Timișoara, Romania
| | | | - Mehmet Ungan
- School of Medicine, Ankara University, Ankara, Turkey
| | | | - Thomas Frese
- University Halle-Wittenberg, Halle (Saale), Germany
- European General Practice Research Network, Halle-Wittenberg, Germany
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Camard L, Liard R, Duverne S, Ibanez G, Skendi M. Consensus on relevant point-of-care ultrasound skills in General Practice: a two-round French Delphi study. BMC MEDICAL EDUCATION 2024; 24:341. [PMID: 38532436 DOI: 10.1186/s12909-024-05072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/18/2024] [Indexed: 03/28/2024]
Abstract
CONTEXT Point-of-Care Ultrasound (POCUS) has become an important tool in the clinical practice of many specialties, but its use and impact in General Practice in France remains to be explored. OBJECTIVE The objective of this study is to obtain a consensus among experienced French general practitioners on a list of relevant POCUS skills in General Practice in 4 anatomical regions. METHOD We used a two-round Delphi method to obtain a consensus. An initial list of skills was drawn by conducting a literature review. To rate each skill, we used a nine-point Likert scale. An interactive meeting between experts took place between Delphi rounds. POCUS experts in General Practice were defined as general practitioners with theoretical training in ultrasound who regularly perform ultrasound, who have performed ultrasound for more than five years and/or are involved in providing ultrasound training. RESULTS 11 French general practitioners screened 83 skills in 4 anatomical regions: abdominal, urogenital, vascular, gynecology and obstetrics. An agreement was obtained for 36 POCUS skills as to their appropriateness in General Practice. There were 17 skills with a strong appropriate agreement (100% of "7-9" ratings) and 19 skills with a relative agreement (100% of "5-9" ratings). CONCLUSION These skills could serve as a basis for guidelines on the use and curriculum of POCUS in General Practice in France as well as in other countries with similar healthcare systems.
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Affiliation(s)
- Louis Camard
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France.
| | - Roxane Liard
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France
| | - Sophie Duverne
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France
| | - Gladys Ibanez
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France
- Pierre-Louis Institute of Epidemiology and Public Health, Paris, France
| | - Mariela Skendi
- Department of General Practice, Faculty of Medicine, Sorbonne University, Paris, France.
- Department of Adult Radiology, Necker Hospital, Paris, France.
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Mans PA, Yogeswaran P, Adeniyi OV. Building Consensus on the Point-of-Care Ultrasound Skills Required for Effective Healthcare Service Delivery at District Hospitals in South Africa: A Delphi Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7126. [PMID: 38063556 PMCID: PMC10705875 DOI: 10.3390/ijerph20237126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Despite the widespread availability of ultrasound machines in South African district hospitals, there are no guidelines on the competency in point-of-care ultrasound (POCUS) use required by generalist doctors in this setting. This study aimed to define the required POCUS competencies by means of consensus via the Delphi method. METHODS An online Delphi process was initiated in June 2022, using the existing American Academy of Family Physicians' ultrasound curriculum (84 skillsets) as the starting questionnaire. Panelists were selected across the country, including two from district hospitals in each province and two from each academic family medicine department in South Africa (N = 36). In each iterative round, the participants were asked to identify which POCUS skillsets were essential, optional (region-specific), or non-essential for South African district hospitals. This process continued until consensus (>70% agreement) was achieved on all of the skillsets. RESULTS Consensus was achieved on 81 of the 84 skillsets after 5 iterative rounds (96.4%), with 3 skillsets that could not achieve consensus (defined as <5% change over more than 2 consecutive rounds). The final consensus identified 38 essential, 28 optional, and 15 non-essential POCUS skillsets for the South African district hospital context. CONCLUSIONS The list of essential POCUS skillsets provided by this study highlights the predominance of obstetric- and trauma-based skillsets required for generalist healthcare workers in South African district hospitals. The findings will require priority setting and revalidation prior to their implementation across the country.
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Affiliation(s)
- Pierre-Andre Mans
- Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa;
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
| | - Parimalaranie Yogeswaran
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
- Department of Family Medicine, Mthatha Regional Hospital, Mthatha 5100, South Africa
| | - Oladele Vincent Adeniyi
- Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa;
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
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Demi L, Wolfram F, Klersy C, De Silvestri A, Ferretti VV, Muller M, Miller D, Feletti F, Wełnicki M, Buda N, Skoczylas A, Pomiecko A, Damjanovic D, Olszewski R, Kirkpatrick AW, Breitkreutz R, Mathis G, Soldati G, Smargiassi A, Inchingolo R, Perrone T. New International Guidelines and Consensus on the Use of Lung Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:309-344. [PMID: 35993596 PMCID: PMC10086956 DOI: 10.1002/jum.16088] [Citation(s) in RCA: 66] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/28/2022] [Accepted: 07/31/2022] [Indexed: 05/02/2023]
Abstract
Following the innovations and new discoveries of the last 10 years in the field of lung ultrasound (LUS), a multidisciplinary panel of international LUS experts from six countries and from different fields (clinical and technical) reviewed and updated the original international consensus for point-of-care LUS, dated 2012. As a result, a total of 20 statements have been produced. Each statement is complemented by guidelines and future developments proposals. The statements are furthermore classified based on their nature as technical (5), clinical (11), educational (3), and safety (1) statements.
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Affiliation(s)
- Libertario Demi
- Department of Information Engineering and Computer ScienceUniversity of TrentoTrentoItaly
| | - Frank Wolfram
- Department of Thoracic and Vascular SurgerySRH Wald‐Klinikum GeraGeraGermany
| | - Catherine Klersy
- Unit of Clinical Epidemiology and BiostatisticsFondazione IRCCS Policlinico S. MatteoPaviaItaly
| | - Annalisa De Silvestri
- Unit of Clinical Epidemiology and BiostatisticsFondazione IRCCS Policlinico S. MatteoPaviaItaly
| | | | - Marie Muller
- Department of Mechanical and Aerospace EngineeringNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Douglas Miller
- Department of RadiologyMichigan MedicineAnn ArborMichiganUSA
| | - Francesco Feletti
- Department of Diagnostic ImagingUnit of Radiology of the Hospital of Ravenna, Ausl RomagnaRavennaItaly
- Department of Translational Medicine and for RomagnaUniversità Degli Studi di FerraraFerraraItaly
| | - Marcin Wełnicki
- 3rd Department of Internal Medicine and CardiologyMedical University of WarsawWarsawPoland
| | - Natalia Buda
- Department of Internal Medicine, Connective Tissue Disease and GeriatricsMedical University of GdanskGdanskPoland
| | - Agnieszka Skoczylas
- Geriatrics DepartmentNational Institute of Geriatrics, Rheumatology and RehabilitationWarsawPoland
| | - Andrzej Pomiecko
- Clinic of Pediatrics, Hematology and OncologyUniversity Clinical CenterGdańskPoland
| | - Domagoj Damjanovic
- Heart Center Freiburg University, Department of Cardiovascular Surgery, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Robert Olszewski
- Department of Gerontology, Public Health and DidacticsNational Institute of Geriatrics, Rheumatology and RehabilitationWarsawPoland
| | - Andrew W. Kirkpatrick
- Departments of Critical Care Medicine and SurgeryUniversity of Calgary and the TeleMentored Ultrasound Supported Medical Interventions Research GroupCalgaryCanada
| | - Raoul Breitkreutz
- FOM Hochschule für Oekonomie & Management gGmbHDepartment of Health and SocialEssenGermany
| | - Gebhart Mathis
- Emergency UltrasoundAustrian Society for Ultrasound in Medicine and BiologyViennaAustria
| | - Gino Soldati
- Diagnostic and Interventional Ultrasound UnitValledel Serchio General HospitalLuccaItaly
| | - Andrea Smargiassi
- Pulmonary Medicine Unit, Department of Medical and Surgical SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Internal Medicine, IRCCS San Matteo Hospital FoundationUniversity of PaviaPaviaItaly
| | - Riccardo Inchingolo
- Pulmonary Medicine Unit, Department of Medical and Surgical SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Internal Medicine, IRCCS San Matteo Hospital FoundationUniversity of PaviaPaviaItaly
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Mans PA, Yogeswaran P, Adeniyi OV. Protocol for a Delphi Consensus Study to Determine the Essential and Optional Ultrasound Skills for Medical Practitioners Working in District Hospitals in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9640. [PMID: 35954999 PMCID: PMC9367781 DOI: 10.3390/ijerph19159640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
With increasing access to point of care ultrasound (POCUS) at district hospitals in South Africa, there is a lack of standardisation of skillsets among medical practitioners working at this level of care. This study protocol aims to use the Delphi process to achieve expert consensus on the essential and optional ultrasound skills required for medical practitioners working in district hospitals in South Africa. In alignment with the Delphi method, several iterative rounds will be implemented from June to November 2022. Purposive sampling will be conducted, through the recruitment of two representatives from each academic department of family medicine and two medical doctors working in district hospitals in each province in the country (N = 36). The POCUS skillsets published by the American Academy of Family Physicians will be circulated in the first iterative round, following which participants may suggest further additions. Once a consensus target of 70% has been achieved, the Delphi process will be finalised. The Delphi process and data analysis will be facilitated by an online Delphi platform. Findings from the study will provide insight into the design of the curriculum for POCUS training for medical practitioners in district hospitals and registrars in family medicine departments across the country.
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Affiliation(s)
- Pierre-Andre Mans
- Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
| | - Parimalaranie Yogeswaran
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
- Department of Family Medicine, Mthatha Regional Hospital, Mthatha 5100, South Africa
| | - Oladele Vincent Adeniyi
- Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
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Andersen CA, Frandsen AK, Valentiner-Branth C, Lykkegaard J, Løkkegaard T, Thomsen JL, Jensen MB, Hansen MP. Introducing point-of-care ultrasound in Danish general practice-elucidating the use through a medical audit. Fam Pract 2021; 38:80-87. [PMID: 32839822 DOI: 10.1093/fampra/cmaa080] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Point-of-care ultrasonography (PoCUS) is increasingly used across the medical field. PoCUS is also being implemented in general practice despite a lack of clinical guidelines and training programs for general practitioners (GPs). OBJECTIVES This study aimed to elucidate the employment of PoCUS by Danish GPs following a short training program. METHODS Thirty GPs were enrolled in a short ultrasound training program and taught how to perform 22 selected scanning modalities. In the following 3 months, the GPs registered all performed PoCUS examinations according to the Audit Project Odense method. After 5 months, the GPs were invited to participate in an evaluation seminar, where questionnaires were distributed. RESULTS During the registration period, 1598 patients were examined with PoCUS. A total of 1948 scanning modalities were registered, including 207 examinations outside the taught curriculum. The majority of the ultrasound examinations were performed within 10 minutes (89%), most were considered to be conclusive (87%) and/or to increase diagnostic certainty (67%), whereas one in four examinations entailed a change in patient management. Most GPs attending the evaluation seminar continued to use PoCUS and found the scanning modalities included in the course curriculum relevant in their daily work. CONCLUSION The GPs found several indications for performing PoCUS following the attendance of a 2-day basic training program. The majority of examinations were registered to be conclusive and/or increase diagnostic certainty. However, few GPs used PoCUS on a daily basis and not all examinations were registered to have an impact on patient care.
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Affiliation(s)
| | | | | | - Jesper Lykkegaard
- Audit Project Odense, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | | | | | | | - Malene Plejdrup Hansen
- Center for General Practice at Aalborg University, Aalborg.,Audit Project Odense, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
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