Assessment of Point-of-Care Ultrasound Accuracy in Estimating Left Ventricular Ejection Fraction by Internal Medicine Trainees: A Prospective Observational Study

Author:

Santirotjanakul Asama1,Assavapokee Taweevat1

Affiliation:

1. Mahidol University

Abstract

Abstract

Background In internal medicine, resident physicians play a crucial role in initial patient assessments, necessitating proficiency in left ventricular ejection function (LVEF) evaluation. Point-of-Care Ultrasound (POCUS) offers a potential alternative to formal transthoracic echocardiography (TTE) for LVEF assessment, yet its utility among internal medicine residents remains underexplored. Aims This prospective observational study aimed to evaluate the accuracy of POCUS performed by internal medicine residents in predicting LVEF compared to formal TTE conducted by sonographers and interpreted by cardiologists. Method Thirty-five inpatients underwent both POCUS and formal TTE for LVEF estimation by internal medicine residents and cardiologists, respectively. Internal medicine residents received training sessions on POCUS, consisting of lectures and hands-on practice. Results Internal medicine residents demonstrated excellent proficiency in LVEF assessment, achieving a 97.14% accuracy rate in distinguishing between normal and abnormal function. Agreement between residents and cardiologists on abnormality detection was substantial (κ = 0.9249 ; p < 0.001). Additionally, residents accurately categorized LVEF into severity categories in 91.43% of cases, with substantial agreement observed (κ = 0.7831; p < 0.001). Conclusions Our study highlights the potential of POCUS as a viable alternative to traditional TTE for LVEF assessment in clinical practice. Despite limitations such as sample size and lack of outpatient data, the findings underscore the importance of integrating POCUS training into internal medicine residency programs. Further research is warranted to validate these findings and explore the broader applications of POCUS in cardiovascular care.

Publisher

Springer Science and Business Media LLC

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