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Scand J Prim Health Care · Sep 2024
Multicenter StudyImplementation of lung ultrasonography by general practitioners for lower respiratory tract infections: a feasibility study.
- Félix Amiot, Thomas Delomas, François-Xavier Laborne, Thomas Ecolivet, Richard Macrez, and Axel Benhamed.
- Emergency Department-SAMU50, Centre Hospitalier Mémorial Saint-Lô, Saint-Lô, France.
- Scand J Prim Health Care. 2024 Sep 1; 42 (3): 463470463-470.
ObjectiveTo evaluate the feasibility of lung ultrasonography (LUS) performed by novice users' general practitioners (GPs) in diagnosing lower respiratory tract infections (LRTIs) in primary health care settings.DesignA prospective interventional multicenter study (December 2019-March 2020).Settings And SubjectsPatients aged >3 months, suspected of having LRTI consulting in three different general practices (GPs) (rural, semirural and urban) in France.Main Outcome MeasuresFeasibility of LUS by GPs was assessed by (1) the proportion of patients where LUS was not performed, (2) technical breakdowns, (3) interpretability of images by GPs, (4) examination duration and (5) patient perception and acceptability.ResultsA total of 151 patients were recruited, and GPs performed LUS for 111 (73.5%) patients (LUS group). In 99.1% (n = 110) of cases, GPs indicated that they were able to interpret images. The median [IQR] exam duration was 4 [3-5] minutes. LRTI was diagnosed in 70.3% and 60% of patients in the LUS and no-LUS groups, respectively (p = .43). After LUS, GPs changed their diagnosis from 'other' to 'LRTI' in six cases (+5.4%, p < .001), prescribed antibiotics for five patients (+4.5%, p = .164) and complementary chest imaging for 10 patients (+9%, p < .001). Patient stress was reported in 1.8% of cases, 81.7% of patients declared that they better understood the diagnosis, and 82% of patients thought that the GP diagnosis was more reliable after LUS.ConclusionsLUS by GPs using handheld devices is a feasible diagnostic tool in primary health care for LRTI symptoms, demonstrating both effectiveness and positive patient reception.Trial Registration NumberClinicaltrial.gov: NCT04602234, 20/10/2020.
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