Abstract Aims Inpatients frequently require echo evaluation during consultation rounds in non-cardiology departments, however routine standard echocardiography (SE) requires transport to echo lab. We evaluated the diagnostic accuracy and cost-effectiveness of a handheld ultrasound device (HUD) for cardiac evaluation during consultation sessions in non-cardiology settings. Methods The study comprised 139 patients (mean age 68±17 years, 52% male) referred for SE after cardiology consultation in non-cardiology departments. Before transport to echo lab, all patients were scanned with the HUD by the consulting cardiologist, and it was noted whether the clinical question was answered. The following parameters were assessed: left ventricular (LV) and right ventricular (RV) size and function, significant valvular heart disease (VHD), pericardial effusion, and inferior vena cava (IVC) size and collapse. A cost-minimization analysis was conducted to compare the cost of SE referral vs. HUD-first strategy from the hospital’s perspective. Results In 118 (85%) patients, it was possible to successfully answer the clinical question using the HUD. There was excellent agreement for the detection of abnormal LV size and function (k=0.964), abnormal RV size and function (k=0.943), pericardial effusion (k=0.953), abnormal IVC size and collapse (k=0.941). There was good agreement for the detection of significant VHD (k=0.706). The HUD-first approach led to 74% reduction in echo-related costs. Conclusions This study demonstrates that HUDs could be used by experts as a cost-saving first-line approach for cardiac evaluation in non-cardiology inpatient settings, with high diagnostic accuracy. These findings support the selective adoption of a HUD-first strategy in consultative cardiology practice, when examinations are performed by trained cardiologists and integrated within a structured diagnostic pathway.
Papadopoulou et al. (Thu,) studied this question.