Briefly Trained Medical Students Can Effectively Identify Rheumatic Mitral Valve Injury Using a Hand-Carried Ultrasound

Background Rheumatic heart disease (RHD) is common and remains a major cause of morbidity, particularly in developing countries. Its diagnosis relies on expertise‐dependent echocardiographic studies. We evaluated the accuracy of briefly trained examiners in identifying RHD utilizing a hand‐carried c...

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Bibliographic Details
Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2013-07, Vol.30 (6), p.621-626
Main Authors: Shmueli, Hezzy, Burstein, Yuval, Sagy, Iftach, Perry, Zvi H., Ilia, Ruben, Henkin, Yaakov, Shafat, Tali, Liel-Cohen, Noah, Kobal, Sergio L.
Format: Article
Language:English
Subjects:
Age
Curriculum
echocardiography
Echocardiography - statistics & numerical data
Education, Medical - organization & administration
Educational Measurement
Female
hand-carried cardiac ultrasound
Humans
Israel
Male
Middle Aged
Mitral Valve Insufficiency - diagnostic imaging
physical examination
Professional Competence - statistics & numerical data
Reproducibility of Results
rheumatic heart disease
Rheumatic Heart Disease - diagnostic imaging
screening
Sensitivity and Specificity
Students, Medical - statistics & numerical data
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Summary:Background Rheumatic heart disease (RHD) is common and remains a major cause of morbidity, particularly in developing countries. Its diagnosis relies on expertise‐dependent echocardiographic studies. We evaluated the accuracy of briefly trained examiners in identifying RHD utilizing a hand‐carried cardiac ultrasound (HCU) device. Methods Three medical students received 8 hours of training in cardiac ultrasound, focused on assessment of rheumatic valve injury and its complications, using a prototype of HCU device, OptiGo. The students, blinded to the patients' medical condition, performed an auscultation‐based physical examination and a focused HCU study on volunteers and patients with known RHD. A standard echocardiography study was used to validate the results. Results Each student performed a physical examination followed by an HCU study on 45 subjects (mean age 57 ± 14 years, 52% men), 14 of whom (31%) had rheumatic mitral valve injury. The students' averaged sensitivity for diagnosing RHD by HCU examination was 81%, while specificity was 95%. The interrater agreement (kappa) of the 3 students' HCU study and the standard echocardiography examination were between 0.55 and 0.88 (P 
ISSN:0742-2822
1540-8175
DOI:10.1111/echo.12122