Examination of a cardiac patient, by using carotid artery ultrasound screening: possibilities of telemedicine

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Abstract

In clinical practice, there is a high workload of ultrasound (US) diagnostic rooms and a long waiting time for patients to be examined. For targeted selection of patients for expert US, it is possible for clinicians to conduct focus studies according to short protocols, which can be implemented using extramobile US devices.

Objective. To assess the possibility of using telemedicine technologies to train cardiologists in an US-assisted primary examination of patients at an outpatient stage, as well as to evaluate the quality of this US by expert doctors.

Material and methods. After briefly learning how to use a Philips Lumify handheld US device, two cardiologists independently examined the carotid arteries of patients, made conclusions about the presence of atherosclerotic plaques, and recorded the time spent on the examination. After each examination, the physician sent a video loop to an US expert, who assessed the quality of scanning.

Results. The investigation enrolled 104 patients. The opinion of a cardiologist on the presence of an atherosclerotic plaque coincided with that of the expert in 66% of cases. The physicians spent an average of <3.5 minutes per examination. The interaction between the cardiologists and the expert enables a 48% load reduction for an US room.

Conclusion. The introduction of a carotid US into a cardiologist’s outpatient practice will be able to substantially decrease the burden on healthcare facilities, by reducing the time required for appointments for cardiovascular diseases. At the same time, not only US diagnosticians, but also cardiologists are unloaded, since there is a decline in the number of secondary visits.

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About the authors

K. M. Arzamasov

Research and Practical Clinical Center for Diagnosis and Telemedicine Technologies, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru

Candidate of Medical Sciences

Russian Federation, Moscow

V. O. Bushuev

Molecular Diagnosis Center, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: yu.shumskaia@npcmr.ru

Candidate of Medical Sciences

Russian Federation, Moscow

A. V. Vladzymyrskyy

Research and Practical Clinical Center for Diagnosis and Telemedicine Technologies, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru

Doctor of Medical Sciences

Russian Federation, Moscow

K. R. Kozaeva

Consultative and Diagnostic Polyclinic One Hundred and Twenty-One, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru
Russian Federation, Moscow

V. V. Kondratyeva

Consultative and Diagnostic Polyclinic One Hundred and Twenty-One, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru
Russian Federation, Moscow

E. A. Kostenko

Research and Practical Clinical Center for Diagnosis and Telemedicine Technologies, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru
Russian Federation, Moscow

D. V. Leonov

Research and Practical Clinical Center for Diagnosis and Telemedicine Technologies, Moscow City Healthcare Department; National Research University “Moscow Power Engineering Institute”

Email: yu.shumskaia@npcmr.ru
Russian Federation, Moscow; Moscow

O. V. Omelyanskaya

Research and Practical Clinical Center for Diagnosis and Telemedicine Technologies, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru
Russian Federation, Moscow

R. V. Reshetnikov

Research and Practical Clinical Center for Diagnosis and Telemedicine Technologies, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru

Candidate of Physical and Mathematical Sciences

Russian Federation, Moscow

Yu. F. Shumskaya

Research and Practical Clinical Center for Diagnosis and Telemedicine Technologies, Moscow City Healthcare Department; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: yu.shumskaia@npcmr.ru
Russian Federation, Moscow; Moscow

E. V. Sorokina

Consultative and Diagnostic Polyclinic One Hundred and Twenty-One, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru
Russian Federation, Moscow

A. A. Tyazhelnikov

Consultative and Diagnostic Polyclinic One Hundred and Twenty-One, Moscow City Healthcare Department

Email: yu.shumskaia@npcmr.ru
Russian Federation, Moscow

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2. Changes in the scores of the investigation participants (a – Cardiologist A; б – Cardiologist B): solid black line – the physicians’ mean scores from the results of individual sessions; vertical lines – 95% confidence intervals (CI) for the estimates; dotted black line – prediction of further changes, by using the EST model; gray lines – 95% CI for prediction

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