CARDIOVASCULAR MEDICINE

Clinical utility and cost effectiveness of a personal ultrasound imager for cardiac evaluation during consultation rounds in patients with suspected cardiac disease

E C Vourvouri¹, L Y Koroleva², F J Ten Cate¹, D Poldermans¹, A F L Schinkel¹, R T van Domburg¹, W B Vletter¹, J R T C Roelandt¹

¹ Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, Netherlands
² Department of Internal Diseases, Medical Academy of Nizhny, Novgorod, Russia

Correspondence to:
Correspondence to:
Prof Dr J R T C Roelandt, Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands;
j.r.t.c.roelandt{at}erasmusmc.nl

Objective: To assess the clinical utility and cost effectiveness of a personal ultrasound imager (PUI) during consultation rounds for cardiac evaluation of patients with suspected cardiac disease.

Methods: 107 unselected patients from non-cardiac departments (55% men) were enrolled in the study. After the physical examination the consultant cardiologist performed an echocardiographic study with a PUI. The final report was given instantly to the referring physician. All patients subsequently underwent a study with a standard echocardiographic device (SED). For each patient the consultant cardiologist noted whether the findings of the PUI were adequate for final diagnosis. The total cost when full echocardiography was used was compared with the cost when the PUI was used. The time interval from request to diagnosis was also compared.

Results: In 84 (78.5%) patients no further examination with an SED was regarded as necessary. Twenty three patients (21.5%) required a further detailed examination with the SED because of the need for haemodynamic information. There was an excellent agreement for the detection of abnormalities between the two devices (96%). The total cost was €132 per patient with the SED and €75 per patient with the PUI. According to this study, the use of the PUI can lead to a 33.4% reduction of total cost. The mean time from request to diagnosis at the authors’ institution was four days for the SED and instantly for the PUI, for additional potential cost savings.

Conclusions: Immediate echocardiographic assessment during consultation rounds can lead to significant cost savings and can shorten the time to diagnosis.

Keywords: cost effectiveness; personal ultrasound imager; hand held ultrasound device; clinical usefulness

Abbreviations: PUI, personal ultrasound imager; SED, standard echocardiographic device

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Flu, W.-J., van Kuijk, J.-P., Merks, E. J.W., Kuiper, R., Verhagen, H. J.M., Bosch, J. G., Bom, N., Bax, J. J., Poldermans, D. (2009). Screening for abdominal aortic aneurysms using a dedicated portable ultrasound system: early results. Eur J Echocardiogr 10: 602-606 [Abstract] [Full Text]  
• Badano, L. P., Nucifora, G., Stacul, S., Gianfagna, P., Pericoli, M., Del Mestre, L., Buiese, S., Compassi, R., Tonutti, G., Di Benedetto, L., Fioretti, P. M. (2009). Improved workflow, sonographer productivity, and cost-effectiveness of echocardiographic service for inpatients by using miniaturized systems. Eur J Echocardiogr 10: 537-542 [Abstract] [Full Text]  
• Egan, M., Ionescu, A. (2008). The pocket echocardiograph: a useful new tool?. Eur J Echocardiogr 9: 721-725 [Abstract] [Full Text]  
• Trambaiolo, P, Papetti, F, Posteraro, A, Amici, E, Piccoli, M, Cerquetani, E, Pastena, G, Gambelli, G, Salustri, A (2007). A hand-carried cardiac ultrasound device in the outpatient cardiology clinic reduces the need for standard echocardiography. Heart 93: 470-475 [Abstract] [Full Text]  
• Piccoli, M., Trambaiolo, P., Salustri, A., Cerquetani, E., Posteraro, A., Pastena, G., Amici, E., Papetti, F., Marincola, E., La Carruba, S., Gambelli, G. (2005). Bedside Diagnosis and Follow-up of Patients With Pleural Effusion by a Hand-Carried Ultrasound Device Early After Cardiac Surgery. Chest 128: 3413-3420 [Abstract] [Full Text]  
• de Groot-de Laat, L. E, ten Cate, F. J., Vourvouri, E. C, van Domburg, R. T, Roelandt, J. R.T.C (2005). Impact of hand-carried cardiac ultrasound on diagnosis and management during cardiac consultation rounds. Eur J Echocardiogr 6: 196-201 [Abstract] [Full Text]  
• Vourvouri, E C, Poldermans, D, Deckers, J W, Parharidis, G E, Roelandt, J R T C (2005). Evaluation of a hand carried cardiac ultrasound device in an outpatient cardiology clinic. Heart 91: 171-176 [Abstract] [Full Text]  
• Kobal, S. L., Atar, S., Siegel, R. J. (2004). Hand-Carried Ultrasound Improves the Bedside Cardiovascular Examination. Chest 126: 693-701 [Abstract] [Full Text]  
• Roelandt, J. R. T. C. (2003). The 50th anniversary of echocardiography: are we at the dawn of a new era?. Eur J Echocardiogr 4: 233-236 [Full Text]  
• Salustri, A, Trambaiolo, P (2003). The "ultrasonic stethoscope": is it of clinical value?. Heart 89: 704-706 [Full Text]