Journal Article

Pocket-sized echocardiography for screening structural heart disease: diagnostic accuracy and cost-effectiveness for population-based studies

Ghavidel, Alireza A., Kazemborji, Bahareh, Rezaei, Yousef, Mohebbi, Ahmad, Omrani, Gholamreza, Peighambari, Mohammad M., Maleki, Majid, Hosseini, Saeid, Tabib, Avisa, Samiei, Niloufar, Rashidi Ghader, Fariba, Moradian, Maryam, Noohi, Feridoun

2020

Overview

The standard transthoracic echocardiography has some limitations in emergent and community-based situations. The emergence of pocket-sized ultrasound has led to influential advancements. In this prospective study, in the hospital-based phase, children with suspected structural heart diseases were enrolled. In the school-based phase, healthy children were randomly selected from six schools. All individuals were examined by experienced operators using both the standard and the pocket-sized echocardiography. A total of 73 individuals with a mean age of 9.9 ± 3.2 years in the hospital-based cohort and 143 individuals with a mean age of 12.8 ± 2.9 years in the school-based cohort were examined. The agreements between the standard and the pocket-sized echocardiography were good or excellent for major CHDs in both cohorts (κ statistics > 0.61). Among valvular pathologies, agreements for tricuspid and pulmonary valves' regurgitation were moderate among school-based cohorts (0.56 [95% confidence interval 0.12-1] and 0.6 [95% confidence interval 0.28-0.91], respectively). The agreements for tricuspid and pulmonary valves' regurgitation were excellent (>0.9) among hospital-based population. Other values for valvular findings were good or excellent. The overall sensitivity and specificity were 87.5% (95% confidence interval 47.3-99.7) and 93.8% (95% confidence interval 85-98.3) among the hospital-based individuals, respectively, and those were 88% (95% confidence interval 77.8-94.7) and 68.4% (95% confidence interval 56.7-78.6) among the school-based individuals, respectively. The cost of examination was reduced by approximately 70% for an individual using the pocket-sized device. When interpreted by experienced operators, the pocket-sized echocardiography can be used as screening tool among school-aged population.

• Publisher: Cambridge University Press
• Subject: Accuracy / Adolescent / Cardiovascular disease / Child / Children / Confidence intervals / Coronary artery disease / Cost analysis / Cost-Benefit Analysis / Echocardiography / Echocardiography, Doppler, Color - economics / Echocardiography, Doppler, Color - instrumentation / Equipment Design / Female / Health Care Costs / Heart / Heart diseases / Heart Diseases - diagnostic imaging / Heart Diseases - economics / Heart valves / Hospitals / Humans / Iran / Laboratories / Male / Materials Testing / Miniaturization / Pediatrics / Population / Population studies / Population-based studies / Predictive Value of Tests / Prospective Studies / Pulmonary valve / Regurgitation / Reproducibility of Results / Teenagers / Ultrasonic imaging / University faculty / Urban areas