18 Vscan View: The Magazine of Vscan
Pocket-Sized Imaging Device (PSID) Effectiveness for Ward-based
Transthoracic Studies1 (TTE); a Clinical and Economic Study
By Silvia Gianstefani1, Norman Catibog1, Almira R. Whittaker1, Antonios G. Ioannidis1, Francesco Vecchio1, Peter T. Wathen1, Abdel Douiri2,
Joseph Reiken1, and Mark J. Monaghan1
The use of a Pocket-sized Imaging Device (PSID) can provide
a valuable alternative to transthoracic echocardiogram (TTE)
in the presence of focused clinical questions, and in the
process, deliver a clear economic advantage in the delivery
of ward-based transthoracic echo service.
During a three-month period at King’s College Hospital, London,
United Kingdom physicians assessed the clinical and economic
usefulness of a PSID in the setting of bedside echo requests.
Physicians established two objectives for the study:
• Clinical: Assess the usefulness of a PSID in evaluating focused
clinical questions including: left ventricular function, presence
of regional wall motion abnormalities, evidence of pericardial
effusion, or exclusion of significant valve pathology.
• Economic: Calculate cost effectiveness of PSID use in limited
cardiac assessments conducted by experienced sonographers.
The study involved 92 inpatients during a three-month
enrollment period where bedside ultrasound was ordered and
performed. In the study involving experienced sonographers
and echocardiography fellows, the Vscan was compared to
Philips CX50 and GE Healthcare Vivid™ i ultrasound systems.
It involved experienced sonographers and echocardiography
fellows, and Kappa statistics were used to estimate the level
of agreement and reproducibility.
Clinical: PSID and TTE image quality
for focused clinical questions
Assessment of the chambers, valves and the presence
of effusion were compared between devices.
PSID: Qualitative assessments performed on the device
T TE: Quantitative measurements performed offline
The results indicate PSID as a valuable alternative to standard
approaches for focused clinical questions in ward-based
echocardiography when performed and interpreted by
• In 90% (83 of 92) of patients the PSID provided the desired
• PSID is useful to exclude major valve pathology, but T TE
including Doppler is required to assess severity of lesions
0% 20% 40% 60% 80% 100%
1. King’s College Hospital, London, UK
2. Department of Public Health Sciences and NIHR BRC, Guy’s and St Thomas’ NHS Trust, King’s College London, London, UK
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