Point-of-Care Ultrasound Use, Accuracy, and Impact on Clinical Decision Making in Rwanda Hospitals

J Ultrasound Med. 2017 Jun;36(6):1189-1194. doi: 10.7863/ultra.16.05073. Epub 2017 Mar 4.


Objectives: Few studies of point-of-care ultrasound training and use in low resource settings have reported the impact of examinations on clinical management or the longer-term quality of trainee-performed studies. We characterized the long-term effect of a point-of-care ultrasound program on clinical decision making, and evaluated the quality of clinician-performed ultrasound studies.

Methods: We conducted point-of-care ultrasound training for physicians from Rwandan hospitals. Physicians then used point-of-care ultrasound and recorded their findings, interpretation, and effects on patient management. Data were collected for 6 months. Trainee studies were reviewed for image quality and accuracy.

Results: Fifteen participants documented 1158 ultrasounds; 590 studies (50.9%) had matched images and interpretations for review. Abdominal ultrasound for free fluid was the most frequently performed application. The mean image quality score was 2.36 (95% confidence interval, 2.28-2.44). Overall sensitivity and specificity for trainee-performed examinations was 94 and 98%. Point-of-care ultrasound use most commonly changed medications administered (42.4%) and disposition (30%).

Conclusions: A point-of-care ultrasound training intervention in a low-resource setting resulted in high numbers of diagnostic-quality studies over long-term follow-up. Ultrasound use routinely changed clinical decision making.

Keywords: education; global health; point of care; ultrasound.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Clinical Competence / statistics & numerical data*
  • Clinical Decision-Making / methods*
  • Cohort Studies
  • Educational Measurement / statistics & numerical data*
  • Female
  • Hospitals / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Point-of-Care Systems / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Reproducibility of Results
  • Rwanda / epidemiology
  • Sensitivity and Specificity
  • Utilization Review*