Intelligent handheld ultrasound improving the ability of non-expert general practitioners in carotid examination for community populations: a prospective and parallel controlled trial

sun, pei; han, hong; sun, yi kang; wang, xi; liu, xiao chuan; zhou, bo yang; wang, li fan; zhang, ya qin; pan, zhi gang; huang, bei jian; xu, hui xiong; zhao, chong ke

doi:.0.0.0

Original Article

Intelligent handheld ultrasound improving the ability of non-expert general practitioners in carotid examination for community populations: a prospective and parallel controlled trial

pei sun^1,2, hong han^1,2, yi kang sun^1,2, xi wang¹, xiao chuan liu¹, bo yang zhou¹, li fan wang¹, ya qin zhang¹, zhi gang pan¹, bei jian huang^1,2, hui xiong xu^1,2, chong ke zhao^1,2

¹General Medicine Department, Zhongshan Hospital, Fudan University, Shanghai, China, shanghai, China
²Shanghai Institute of Imaging Medicine, Shanghai 200032, China, shanghai , China
³General Medicine Department, Zhongshan Hospital, Fudan University, Shanghai, China, shanghai, China

Corresponding Author: chong ke zhao ,Tel: 15800492691, Fax: 02164041990, Email: zhaochongke123@163.com

Received: September 9, 2024; Accepted: November 14, 2024. Published online: November 14, 2024.

ABSTRACT

Purpose:
To investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations.
Methods:
This was a prospective parallel controlled trial that recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs using handheld US devices (setting A, setting B, and setting C). The results of setting C were considered the gold standard. Carotid intima-media thickness (CIMT) and CPs features were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic (ROC) curve. Inter-observer agreement was compared using the intra-group correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits.
Results:
Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited a better diagnostic performance than setting A for detecting CPs (area under the curve: 0.856 vs. 0.749, p < 0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and CPs assessment (ICC: 0.731-0.923). Moreover, measurements with setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both p < 0.01).
Conclusion:
Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of a specialist doctor.

Keywords: Intelligent handheld ultrasound device; General practitioners; Carotid plaque; Carotid stenosis; Plaque-Reporting and Data System (RADS)