Accuracy of focused cardiac ultrasound interpretation among emergency and critical care medicine residents in Ethiopia: A multi-center cross-sectional study

Authors

Nahom Mesfin Mekonen, Department of Emergency and Critical Care Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
Temesgen Beyene Abicho, Department of Emergency and Critical Care Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
Kalsidagn Girma Asfaw, Department of Emergency and Critical Care Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
Tigist Workneh Leulseged, Medical Research Lounge (MRL), Addis Ababa, Ethiopia.
Nebiat Adane Mera, Department of Internal medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
Yegeta Wondafrash Habte, Global Medical Solutions, Abu Dhabi, Zaid Military Hospital.
Fekadesilassie Henok Moges, Advocate Health - MidwestFollow
Yidnekachew Asrat Birhan, Department of Internal Medicine, Cardiology Unit, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
Meron Tesfaye, Department of Emergency and Critical Care Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
Birhanu Tesfaye, Department of Emergency and Critical Care Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.

Recommended Citation

Mekonen NM, Abicho TB, Asfaw KG, et al. Accuracy of focused cardiac ultrasound interpretation among emergency and critical care medicine residents in Ethiopia: A multi-center cross-sectional study. Afr J Emerg Med. 2024;14(3):150-155. doi:10.1016/j.afjem.2024.06.002

Affiliations

Aurora West Allis Medical Center

Abstract

Introduction:Focused cardiac ultrasound (FoCUS) has emerged as a valuable tool in emergency and critical care medicine, allowing for rapid assessment of cardiac function and structure at the bedside. This rapid diagnostic technique holds particular promise in resource-limited settings like Ethiopia, where access to standard echocardiography may be limited and delayed. However, the accuracy of FoCUS interpretation is highly dependent on the operator's skills and expertise. To inform the design of effective interventions, the study aimed to assess the accuracy of FoCUS interpretation and associated factors among senior Emergency Medicine residents at two large referral teaching hospitals in Ethiopia.

Methods:A cross-sectional study was conducted from October to December 2023 among 80 residents at Tikur Anbessa Specialized Hospital and St. Paul's Hospital Millennium Medical College. To assess diagnostic accuracy, 15 pre-selected cardiac ultrasound videos (normal and pathological cases) were selected from American College of Emergency Physicians website and the PoCUS Atlas, and accurate interpretation was defined as correctly answering at least 12 out of 15 readings. A binary logistic regression model was fitted to identify significant factors at the 5% level of significance, where significant results were interpreted using adjusted odds ratio (AOR) with 95% confidence interval (CI).

Result:The overall accuracy in interpreting FoCUS findings was 47.5% (95% CI: 38.8-60.0%), with highest for collapsing Inferior Vena Cava (91.3%) and standstill (90.0%), and lowest for Regional Wall Motion Abnormality of Left Ventricle (46.3%). Residents who received training (AOR=4.14, 95%CI:1.32-13.04, p = 0.015), perceived themselves as skilled (AOR=4.81, 95%CI=1.06-21.82, p = 0.042), and felt confident in acquiring and interpretation (AOR=3.16, 95%CI=1.01-9.82, p = 0.047) demonstrated significantly higher accuracy.

Conclusion:The study identified a low overall accuracy in FoCUS interpretation, with accuracy improving with training and better perceived skill and confidence. Training programs with simulation, continuous education, and mentorship are crucial to enhance these critical skills.

Document Type

Article

PubMed ID

39005756