Pocket-size imaging device: effectiveness for ward-based transthoracic studies

Eur Heart J Cardiovasc Imaging. 2013 Dec;14(12):1132-9. doi: 10.1093/ehjci/jet091. Epub 2013 May 24.


Aims: Pocket-size imaging devices (PSID) are now available; their potential role in a hospital environment has been investigated but still remains undefined.

Methods and results: We evaluated the effectiveness of PSID in 92 patients referred for bedside transthoracic echocardiogram (TTE). Patients were included where there was a focused clinical question: quantification of left ventricular function (LVF); presence of regional wall motion abnormalities (RWMA); evidence of pericardial effusion, exclusion of significant valve pathology. Each patient underwent an echocardiography evaluation using PSID and TTE. In 83 patients [k = 90%, 95% CI (82.2-95.4)], it was possible to answer the clinical question by PSID examination alone. There was agreement between the findings of PSID and TTE in 86 cases [79%; k = 47%, 95% CI (12.8-82.0)], in three cases, the clinical question was not answered by both modalities. When the clinical question was focused on LVF, the agreement was excellent [k = 96%, 95% CI (95.3-97.9)], as was the agreement in the detection of RWMA [k = 94.57%, 95% CI (82.4-95.1)]. There was also good concordance in the detection of valve pathology and pericardial effusion. Using PSID, the reduction in the scanning and reporting time was 66%. The cost-effectiveness analysis produced very favourable results: with PSE, we obtained an overall cost saving per scan of 76%, compared with TTE.

Conclusion: This study demonstrates that PSID can provide a valuable alternative to TTE in the presence of focused clinical questions and can provide an efficient way of delivering a ward-based transthoracic echo service.

Keywords: Cost-effectiveness; Pocket-size imaging devices; Transthoracic echocardiogram.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / diagnostic imaging*
  • Cohort Studies
  • Cost-Benefit Analysis
  • Diagnostic Imaging / instrumentation
  • Diagnostic Imaging / methods
  • Echocardiography / economics*
  • Echocardiography / instrumentation*
  • Echocardiography / methods
  • Equipment Design / economics
  • Equipment Safety / economics
  • Female
  • Forecasting
  • Humans
  • Male
  • Middle Aged
  • Miniaturization / methods*
  • Observer Variation
  • Point-of-Care Systems / economics
  • Point-of-Care Systems / trends*
  • Reproducibility of Results
  • United Kingdom