scholarly journals Adoptability and accuracy of point‐of‐care ultrasound in screening for valvular heart disease in the primary care setting

2021 ◽  
Author(s):  
Yashasvi Chugh ◽  
Opema Lohese ◽  
Paul Sorajja ◽  
Ross Garberich ◽  
Larissa Stanberry ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Point Of Care Ultrasound

scholarly journals Adoptability and Accuracy of Point-of-Care Ultrasound in Screening for Valvular Heart Disease in the Primary Care setting

2021 ◽  
Author(s):  
Yashasvi Chugh ◽  
Opema Lohese ◽  
Paul Sorajja ◽  
Ross Garberich ◽  
Lariss Stanberry ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Primary Care Providers ◽  
Left Ventricular ◽  
Point Of Care Ultrasound ◽  
Care Providers

Background: Despite continued efforts, the majority of patients with valvular heart disease (VHD) remain undiagnosed and untreated. This study aimed to assess the adoptability and accuracy of point-of-care handheld echocardiographic assessments (POCE) in the primary care setting. Methods: Eleven previously untrained primary care providers were trained to use the Vscan Extend (GE, WI) POCE to assess VHD, left ventricular function (LVEF), and major extra-cardiac findings. Their assessments were compared to those of 3 blinded expert readers. A total of 180 assessments were evaluated using Kappa statistics (κ) together with their estimated standard error, p-value, and 95% CI bounds. Results: Identical or nearly identical agreement between previously untrained primary providers and expert readers was evident for the diagnosis of tricuspid regurgitation, mitral regurgitation, pericardial effusion, volume status. These agreements were strongest in apical long axis (κ =1, p<0.001) and parasternal long and short axis views (k>=0.82 p<0.001), though agreement remained robust in apical 4-chamber views (k>=0.76). The agreements in LVEF assessment were identical in the apical long axis view (κ =1, p<0.001) and robust in the remaining 3 views (κ>=0.66, p<0.001). The assessments of aortic stenosis (parasternal/long, κ =0.42, and parasternal/short, κ =0.47, both p<0.001) were weak in their agreement. Conclusion: Compared to expert echocardiography readers, the untrained providers’ use of POCE for VHD shows high user adoptability and diagnostic accuracies in the primary care setting.

scholarly journals ADOPTABILITY AND ACCURACY OF POINT-OF-CARE ULTRASOUND IN SCREENING FOR VALVULAR HEART DISEASE IN THE PRIMARY CARE SETTING

2021 ◽  
Vol 77 (18) ◽  
pp. 1711
Author(s):  
Opema Lohese ◽  
Ross Garberich ◽  
Larissa Stanberry ◽  
Paul Sorajja ◽  
Joao Cavalcante ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Point Of Care Ultrasound

1306-P: Cost Effectiveness of Point-of-Care HbA1c in Primary Care Setting in Brazil

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1306-P
Author(s):  
DANIELLE S. MEDEIROS ◽  
LORENA S. ROSA ◽  
SOSTENES MISTRO ◽  
CLAVDIA N. KOCHERGIN ◽  
DANIELA A. SOARES ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care

Improved infrared spectrophotometer for point-of-care patient 13C-urea breath testing in the primary care setting

2005 ◽  
Vol 38 (8) ◽  
pp. 731-734 ◽  
Author(s):  
Antone R. Opekun ◽  
Ann B. Gotschall ◽  
Nageeb Abdalla ◽  
Cornelia Agent ◽  
Elizabeth Torres ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Care Patient ◽  
Breath Testing ◽  
Infrared Spectrophotometer ◽  
Urea Breath Testing

Understanding the Fontan Procedure in Congenital Heart Disease Patients and the Importance of Early Hepatology Referrals: A Case Study

2018 ◽  
Vol 11 (2) ◽  
pp. 95-99
Author(s):  
Alice Chan
Keyword(s):  
Primary Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Nurse Practitioners ◽  
Congenital Heart ◽  
Care Setting ◽  
Primary Care Setting ◽  
Fontan Procedure ◽  
Early Screening

Background: Patients with congenital heart disease are surviving into adulthood because of new surgeries developed over the recent decades. One surgery is the Fontan procedure, which is used in patients with only one functioning ventricle. Although it has been saving lives, in the recent years multiple complications have been noted. Objective: To discuss the Fontan procedure and inform nurse practitioners in the primary care setting the importance of early screening and referral because of increasing number of liver complications in these patients. This case study highlights the dilemmas a patient with the Fontan procedure faces as a young adult. Methods: Evidence-based articles from the PubMed and Embase databases were used to support the case study. Results: Patients with the low-pressure Fontan circulation are under chronic passive congestion and have known liver complications such as liver fibrosis, cirrhosis, and protein-losing enteropathy. This can lead to a high-risk dual organ heart–liver transplant. Conclusions: Early screening and referral to a hepatologist are critical in these patients. Implications for Nursing: Since patients with congenital heart disease often present to the primary care setting, nurse practitioners in this area should understand the Fontan procedure and its associated complications so they can effectively manage these patients.

scholarly journals Point‐of‐care ultrasound: Closing guideline gaps in screening for valvular heart disease

2020 ◽  
Vol 43 (12) ◽  
pp. 1368-1375
Author(s):  
Muhammad Hammadah ◽  
Christopher Ponce ◽  
Paul Sorajja ◽  
João L. Cavalcante ◽  
Santiago Garcia ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Point Of Care ◽  
Point Of Care Ultrasound

IMPROVED INFRARED SPECTROSCOPY FOR POINT OF CARE PATIENT 13 C-UREA BREATH TESTING IN THE PRIMARY CARE SETTING

2004 ◽  
Vol 99 ◽  
pp. S30
Author(s):  
Antone R. Opekun ◽  
Ann Gotschall ◽  
Nageeb Abdalla ◽  
Cornelia Agent ◽  
Elizabeth Torres ◽  
...  
Keyword(s):  
Primary Care ◽  
Infrared Spectroscopy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Care Patient ◽  
Breath Testing ◽  
Urea Breath Testing

scholarly journals Does use of point-of-care testing improve cost-effectiveness of the NHS Health Check programme in the primary care setting? A cost-minimisation analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015494 ◽  
Author(s):  
Austen El-Osta ◽  
Maria Woringer ◽  
Elena Pizzo ◽  
Talitha Verhoef ◽  
Claire Dickie ◽  
...  
Keyword(s):  
Primary Care ◽  
Laboratory Testing ◽  
Care Setting ◽  
Primary Care Setting ◽  
Disease Risk ◽  
Point Of Care ◽  
Health Check ◽  
Point Of Care Testing ◽  
General Practices ◽  
Nhs Health Check

ObjectiveTo determine if use of point of care testing (POCT) is less costly than laboratory testing to the National Health Service (NHS) in delivering the NHS Health Check (NHSHC) programme in the primary care setting.DesignObservational study and theoretical mathematical model with microcosting approach.SettingWe collected data on NHSHC delivered at nine general practices (seven using POCT; two not using POCT).ParticipantsWe recruited nine general practices offering NHSHC and a pathology services laboratory in the same area.MethodsWe conducted mathematical modelling with permutations in the following fields: provider type (healthcare assistant or nurse), type of test performed (total cholesterol with either lab fasting glucose or HbA1c), cost of consumables and variable uptake rates, including rate of non-response to invite letter and rate of missed [did not attend (DNA)] appointments. We calculated total expected cost (TEC) per 100 invites, number of NHSHC conducted per 100 invites and costs for completed NHSHC for laboratory and POCT-based pathways. A univariate and probabilistic sensitivity analysis was conducted to account for uncertainty in the input parameters.Main outcome measuresWe collected data on cost, volume and type of pathology services performed at seven general practices using POCT and a pathology services laboratory. We collected data on response to the NHSHC invitation letter and DNA rates from two general practices.ResultsTEC of using POCT to deliver a routine NHSHC is lower than the laboratory-led pathway with savings of £29 per 100 invited patients up the point of cardiovascular disease risk score presentation. Use of POCT can deliver NHSHC in one sitting, whereas the laboratory pathway offers patients several opportunities to DNA appointment.ConclusionsTEC of using POCT to deliver an NHSHC in the primary care setting is lower than the laboratory-led pathway. Using POCT minimises DNA rates associated with laboratory testing and enables completion of NHSHC in one sitting.

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