Key result
EM resident visual estimation and EPSS accurately estimate LVEF and correlate moderately with 2D echo.
Why the study?
Does point-of-care ultrasound performed by emergency medicine residents accurately assess left ventricular systolic function compared to conventional 2D echocardiography in adult patients with acute dyspnea?
Observational (n=112)
No
Does point-of-care ultrasound performed by emergency medicine residents accurately assess left ventricular systolic function compared to conventional 2D echocardiography in adult patients with acute dyspnea?
Effect estimate: Spearman's r=0.422 (visual) and 0.411 (EPSS)
Bedside ultrasonography by emergency medicine residents is a valuable tool for initial assessment of left ventricular systolic function in acute dyspnea, showing high sensitivity for detecting severely reduced ejection fraction.
Supports rapid bedside LVEF assessment by EM residents in emergencies; confirms accuracy versus 2D echocardiography and extends evidence to acute care.
Background: Point-of-care ultrasound (POCUS) has become a crucial tool in the emergency department, aiding in rapid patient assessment and diagnosis, particularly in cases of acute dyspnea, which can have life-threatening causes. This study explores the diagnostic accuracy of PoCUS performed by emergency medicine residents, utilizing visual estimation and E-Point Septal Separation (EPSS) methods, in comparison to conventional 2D echocardiograms interpreted by sonographers. Methods: A total of 112 adult patients with acute dyspnea were included in this non-inferiority study. Visual estimation and EPSS measurements were performed by trained emergency medicine residents, with the results compared to 2D echocardiograms for sensitivity, specificity, positive and negative predictive values, likelihood ratios, receiver operating characteristic curve and diagnostic accuracy. Results: The study demonstrated a moderate positive correlation between visual estimation and EPSS methods and 2D echocardiography findings, with a Spearman's correlation coefficient of 0.422 and 0.411, respectively. The visual estimation method showed higher positive likelihood ratios (107) and sensitivity (100%) for detecting severely reduced ejection fraction (EF) < 30%, while EPSS displayed slightly lower positive likelihood ratios (13.4) and sensitivity (100%) in the same category. The diagnostic accuracy for both methods was highest in patients with severely depressed EF and lowest in those with moderately depressed EF. The study revealed some discrepancies in classification between methods, with visual estimation and EPSS sometimes underestimating or overestimating EF, potentially due to patient factors and operator-dependent bias. Conclusion: This study demonstrates that visual estimation and EPSS methods, when performed by emergency medicine residents, exhibit a moderate positive correlation with 2D echocardiography findings. These methods offer a statistically significant diagnostic accuracy in estimating left ventricular ejection fraction, making them valuable tools for initial assessment in time-sensitive situations.
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Göker et al. (2026) conducted an observational in Acute dyspnea (n=112). Point-of-care ultrasound (visual estimation and EPSS) by emergency medicine residents vs. 2D echocardiography performed by sonographers was evaluated on Diagnostic accuracy and correlation with 2D echocardiography findings (Spearman's r=0.422 (visual) and 0.411 (EPSS)). Point-of-care ultrasound visual estimation and EPSS by emergency residents showed moderate correlation (r=0.422 and 0.411) with 2D echo, with 100% sensitivity for detecting EF <30%.
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