Dyspnea Clinical Trial
Official title:
Interest of Clinical Ultrasound in Patients Consulting for Dyspnea in the Emergency Department: an Observational Bicentric Study
The diagnostic value of Point-of-care ultrasound (POCUS) in emergency department (ED) dyspneic patients is shown by numerous studies with a limited number of patients. Recently, Zanobetti et al. showed the POCUS diagnostic performance in dyspneic patients in 2600 patients. This study was monocentric and few physicians performed the ultrasounds. Moreover they were experts. The POCUS diagnostic performance performed in a large number of dyspneic ED patients by many physicians with heterogeneous experience is not known. The investigators are carrying out a bicentric study in two large medical teams routinely practicing POCUS. The main objective of this study is to show the diagnostic concordance between the diagnosis resulting from the POCUS results in emergency department dyspneic patients and the diagnosis of discharge from the emergency department in a large medical team with a heterogeneous level of training and experience. The secondary objective is to study these different diagnostic concordances according to the level of ultrasound expertise of the ER practitioners.
- Status of the issue and objective of the research Emergency Clinical Ultrasound (ECU)
has shown excellent diagnostic relevance in patients presenting to emergency departments
for dyspnea. A recent study including more than 2600 dyspneic patients in the emergency
department shows that the diagnosis made with the ECU alone has a good concordance with
the diagnosis of end of management in the emergency department but with a significantly
shorter duration of obtaining it (186 ± 72 min vs 24 ± 10 min p = 0.025). This study,
like many on the ECU, shows good performance when ultrasound is performed by experts.
Confirmation that the ECU has a diagnostic performance comparable to all the
examinations performed in the standard management of dyspneic patients, when applied by
a large team of emergency physicians, is a necessity. The main objective of this study
is to show the diagnostic concordance between the diagnosis resulting from the results
of the ECU in dyspneic patients in the emergency department and the diagnosis at
discharge from the emergency department in a large medical team with a heterogeneous
level of training and experience. The secondary objective is to study these different
diagnostic concordances according to the level of ultrasound expertise of the ER
practitioners.
- Population :
Adult patients (> 18 years old) admitted to the emergency department for a main reason of
dyspnea.
- Method of observation : This will be a prospective bicentric observational study.
- Origin and nature of nominative data collected. Data collected from computerized patient
records.
- Mode of data flow The data collected will be noted on an anonymized Excel file for
analysis.
- Duration and organization of the research Expected duration: 2 years, including an
18-month inclusion period to allow for the inclusion of 2600 patients. Data is collected
by the trial investigators.
- Method of data analysis Descriptive statistical analysis and comparison of concordance
between different diagnostic methods
- Justification of the number of subjects or power analysis. 2600 to allow comparison with
the original publication.
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