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CC BY-NC-ND 4.0 · Ultrasound Int Open 2024; 10: a21961599
DOI: 10.1055/a-2196-1599
Original Article

Bedside Clinical Hand-held Ultrasound in an Internal Medicine Department: The "Bed Med-Us" Experience of Codogno and its Clinical Utility in the Management of Diagnosis and Therapy in 1007 Patients

Francesco Giangregorio 
1   Internal Medicine, Codogno Hospital, Codogno, Italy
,
Emilio Mosconi
1   Internal Medicine, Codogno Hospital, Codogno, Italy
,
Maria Grazia Debellis
1   Internal Medicine, Codogno Hospital, Codogno, Italy
,
Eliana Palermo
1   Internal Medicine, Codogno Hospital, Codogno, Italy
,
Stella Provini
1   Internal Medicine, Codogno Hospital, Codogno, Italy
,
Manuela Mendozza
1   Internal Medicine, Codogno Hospital, Codogno, Italy
,
Laura Ricevuti
1   Internal Medicine, Codogno Hospital, Codogno, Italy
,
Ciro Esposito
1   Internal Medicine, Codogno Hospital, Codogno, Italy
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Abstract

Purpose Handheld ultrasound (HH-US) answers simple clinical questions in emergencies. We performed conventional US with HH-US at the patient’s bedside (BED) during a medical visit (MED) (BED MED-US). The purpose of this prospective study is to estimate BED MED-US reliability, its clinical impact in helping the clinician to formulate correct diagnoses, and its ability to save time and money.

Materials and Methods 1007 patients (519 M; age:76.42) were assessed (from March 2021 to November 2022) in one or more districts. Final diagnosis was determined with clinical and reference tests (chest RX/CT, abdominal CT, endoscopy, etc.). Sensitivity, specificity, LR+ and LR-, and corresponding AUROC were evaluated. HH-US diagnoses were classified as: confirmation (HH-US revealed the sonographic signs that confirmed the clinical diagnosis) (CO), exclusion (HH-US excluded the presence of the ultrasound signs of other pathologies, in the clinical differential diagnosis) (EX), etiological (HH-US reaches diagnosis in clinically doubtful cases) (ET), or clinically relevant incidental (HH-US diagnoses that change the patient's process completely) (INC).

Results HH-US reliability: true-pos: 752; true-neg: 242; false-pos: 7; false-neg: 6 (sens: 99.1%, spec: 97.6%, LR+: 98.5; LR-: 00.15, AUROC: 0.997); clinical impact: CO-diagnosis: 21%; EX: 25%; ET: 47%; INC: 7%; saved time and money: approximately 35,572 minutes of work and 9324 euros.

Conclusion BED MED-US is a reliable clinical imaging system, with an important clinical impact both in diagnosis (etiological in 47%, incidental in 7%) and in the management of personnel resources.

Key words

internal medicine - BED MED-US - point-of-care ultrasound - multi-site ultrasound - handheld ultrasound


Publication History

Received: 29 May 2023

Accepted after revision: 22 October 2023

Article published online:
05 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Bibliographical Record
Francesco Giangregorio, Emilio Mosconi, Maria Grazia Debellis, Eliana Palermo, Stella Provini, Manuela Mendozza, Laura Ricevuti, Ciro Esposito. Bedside Clinical Hand-held Ultrasound in an Internal Medicine Department: The "Bed Med-Us" Experience of Codogno and its Clinical Utility in the Management of Diagnosis and Therapy in 1007 Patients. Ultrasound Int Open 2024; 10: a21961599.
DOI: 10.1055/a-2196-1599
 

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