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Handheld ultrasound to reduce requests for inappropriate echocardiogram (HURRIE)

Echo Research & Practice volume 6, pages 91–96 (2019)Cite this article

Abstract

BackgroundHandheld ultrasound could provide sufficient information to satisfy the clinical questions underlying ‘rarely appropriate’ echo requests, but there are limited data about its use as a gatekeeper to standard echocardiography. We sought to determine whether the use of handheld ultrasound could improve the appropriate use of echocardiography.

Method: A prospective study comparing handheld ultrasound strategy to standard echocardiography for studies deemed rarely appropriate, using a questionnaire based on appropriate use criteria was conducted across two hospitals, from October 2017 to April 2018.

Results: Groups undergoing Handheld ultrasound (n = 76, 58 (46.5–72.5) years, 53 males, 78% outpatients) and standard echocardiography (n = 72, 61 (49.0–71.5) years, 42 males, 76% outpatients) were comparable. There was a significant decrease in the time to scan from just over 1 month in standard group to a median of 12 days in handheld ultrasound group (P < 0.001). This difference was small for inpatients (from 1 day to a median of 10 min in handheld ultrasound, P = 0.014), but prominent in outpatients (from 1.5 months in the standard group to median of 2 weeks in the handheld ultrasound group, P < 0.001). There was no increase in the need for follow-up scan within 6 months and no significant differences in length of hospital stay for inpatients. p]Conclusion: Handheld ultrasound can be an effective gatekeeper to standard echocardiography for requests deemed rarely appropriate, reducing time to echocardiography significantly and potentially decreasing the need for standard echocardiography by up to 20%.

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Funding

Supported in part by a Partnership grant from the National Health and medical Research Council, Canberra, Australia. T H M is in receipt of research support from General Electric Medical Systems for an ongoing research study on the use of strain for the assessment of cardiotoxicity. No external funding was obtained for the study, which was performed with handheld systems loaned by Philips Medical Systems, Andover, MA.

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Authors and Affiliations

  1. Baker Heart and Diabetes Institute, Melbourne, Australia

    Kawa Haji MBChB, Leah Wright PhD & Thomas H. Marwick MBBS PhD MPH

  2. Cardiology Department, Western Health, Melbourne, Australia

    Kawa Haji MBChB, Chiew Wong MBBS PhD, Christopher Neil MBBS PhD, Andrew Mulligan MBBS & Leah Wright PhD

  3. Department of Medicine, University of Melbourne, Melbourne, Australia

    Kawa Haji MBChB, Chiew Wong MBBS PhD, Christopher Neil MBBS PhD, Nicholas Cox MBBS & Sara Vogrin MBBS MBiostat

Authors
  1. Kawa Haji MBChB
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  2. Chiew Wong MBBS PhD
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Correspondence to Thomas H. Marwick MBBS PhD MPH.

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Haji, K., Wong, C., Neil, C. et al. Handheld ultrasound to reduce requests for inappropriate echocardiogram (HURRIE). Echo Res Pract 6, 91–96 (2019). https://doiorg.publicaciones.saludcastillayleon.es/10.1530/ERP-19-0016

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  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1530/ERP-19-0016

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Echo Research & Practice

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