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• W2909585314 abstract "INTRODUCTION:Lung ultrasonography is an up and coming imaging modality which has been studied in the ICU and emergency department setting. It has been shown in multiple small studies that the sensitivity and specificity of the lung ultrasonogram is comparable to a CT scan of the chest. It is cheaper, safer and also requires less expertise to operate.This study was aimed at assessing the diagnostic utility of lung ultrasound in a general medical ward. We compared it prospectively to a composite standard which used clinical diagnosis, chest radiograph and relevant blood tests.The setting was a medical college which caters to lower and middle income patients. The Principle investigator was given training in lung ultrasound and all scans done were checked by the lung ultrasound expert. All patients were those for whom the clinician ordered a chest radiograph for a clinical indication as an in-patient.The findings of the ultrasound and the clinical composite outcomes were compared using sensitivity, specificity, predictive values and likelihood ratios.As we did not exclude many patients we believe the results of our study could be generalised to any hospital in India with predominantly general medical patients.AIM OF THE STUDY:To study the utility of bedside lung ultrasonography compared to a chest radiograph diagnose common respiratory and cardiac conditions in general medical ward.OBJECTIVES:PRIMARY OBJECTIVE:To evaluate sensitivity specificity of beside lung ultrasonography for diagnosis different respiratory and cardiac conditions with a composite reference standard as gold standard in a general medical ward.SECONDARY OBJECTIVES:1. To assess the diagnostic accuracy of a post graduate resident in using lung ultrasonography to correctly diagnose various pathological conditions compared toa trained faculty.2. To assess the diagnostic accuracy of a post graduate resident in using a chest radiograph to correctly diagnose Various pathological conditions compared to a trained faculty.MATERIALS AND METHODS:This was a prospective diagnostic test study conducted at the Christian Medical College, Vellore over the years 2016-2017. The study protocol was approved by the Institutional Review Board, with IRB Min. No. 9820 dated 07.01.2016. (Annexure7).This aim was to evaluate the diagnostic utility of chest ultrasound in a general medical ward.Informed consent was taken from the patient/ patient’s relatives prior to inclusion in the study. (Annexure 3).PATIENT POPULATION:We included all adult patients admitted in the general medicine ward of Christian Medical College, Vellore between June 2016 and August 2017. All patients had either new onset cardiac or respiratory symptoms or signs for which a chest radiograph was done. All eligible patients were consecutively recruited Selection was independent of results of the index test. The whole sample received administration of both tests in a blind manner.INCLUSION CRITERIA:1. Age 18 years or older.2. Patients presenting with respiratory or cardiac complaints or signs for whom a CXR was done.3. In-patients with new onset respiratory or cardiac complaints or signs for whom a CXR was done.EXCLUSION CRITERIA:1. Age less than 18 years,2. Woman who are pregnant,3. Subcutaneous emphysema over the chest.SETTING:This study was carried out in the general medical wards C, E, I and MTS - 4 of Christian Medical College and Hospital, Vellore.CONCLUSION:1. The sensitivity, specificity, positive and negative likelihood ratios for lung ultrasound for all lung conditions were 82%, 78%, 3.78 and 0.22, respectively, as compared to a composite reference standard.2. Among patients with CT scan included as a composite reference standard the sensitivity, specificity, positive and negative likelihood ratios for lung ultrasound for all lung conditions were 88%, 93%, 12 and 0.13, respectively.3. For patients with pulmonary edema the sensitivity, specificity, positive and negative likelihood ratios were 47%, 97%, 16 and 0.54, respectively.4. The agreement between the investigator (resident) and the expert in lung ultrasonogram was 77% (kappa), with a small but reasonable amount of training.5. The time taken for Ultrasound chest was an average of 10 minutes.6. The cost of lung ultrasound in our institution was INR 820 as compared with a CT Thorax of INR 7200." @default.
• W2909585314 created "2019-01-25" @default.
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• W2909585314 date "2018-05-01" @default.
• W2909585314 modified "2023-09-27" @default.
• W2909585314 title "Bedside Lung Ultrasonography in a General Medical Ward: Comparison with Chest Radiography (BLUR)" @default.
• W2909585314 hasPublicationYear "2018" @default.
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