Do you need expensive ultrasound machines to get the diagnosis right?

A hand held ultrasound machine

Doctors love fancy bits of kit, and there is no better example of this than when it comes to ultrasound ┬áimaging. There are fabulous machines around that give spectacular images – but how good does an image have to be to get the diagnosis right? -

My colleague Ahmad Sayasneh published a paper yesterday in the journal Ultrasound in Obstetrics and Gynecology – in which he showed that small hand-held ultrasound machines of the type pictures on the left can give very useful information in a variety of clinical situations. In his study of 204 patients he looked at whether management based on the hand held machine was any different to when a large very expensive department machine was used. Surprisingly in only 2 cases would immediate management have been different. The images obtained were not as good – but the point is that the images were good enough to make a sensible clinical decision.

This is particularly important in early pregnancy care. A women with bleeding and pain in early pregnancy needs to know if the pregnancy is in the right place (i.e. not an ectopic pregnancy) and if there is a heartbeat in order to be reassured about viability. It seems small inexpensive hand held machines can do this satisfactorily in most cases. These machines are light and truly pocket sized – and one imagines it should be possible to “toughen” them and enable them to be recharged using solar power or a car battery – and so make them useful in many environments where ultrasound may not be available. ┬áI need to declare my bias – as I work with Ahmad – but I think this is an important paper that may lead to much better accessibility to ultrasound.

 

 

Professor Tom Bourne

Professor Tom Bourne is Adjunct Professor at Imperial College London, and Consultant Gynaecologist at Queen Charlotte's and Chelsea Hospital. He is also visiting Professor at KU Leuven, Belgium. He has extensive clinical and research experience in early pregnancy care as well as gynaecological ultrasound. He has published over 300 academic papers with an H-index of 63. He advises NICE, is trustee of the ectopic pregnancy trust, President of the UK association of early pregnancy units (AEPU) and on the board of ISUOG. He has a private practice at The Women's Ultrasound Centres at 86 Harley Street and Parkside Hospital in Wimbledon.

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About Professor Tom Bourne

Professor Tom Bourne is Adjunct Professor at Imperial College London, and Consultant Gynaecologist at Queen Charlotte's and Chelsea Hospital. He is also visiting Professor at KU Leuven, Belgium. He has extensive clinical and research experience in early pregnancy care as well as gynaecological ultrasound. He has published over 300 academic papers with an H-index of 63. He advises NICE, is trustee of the ectopic pregnancy trust, President of the UK association of early pregnancy units (AEPU) and on the board of ISUOG. He has a private practice at The Women's Ultrasound Centres at 86 Harley Street and Parkside Hospital in Wimbledon.
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