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Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?

Background: With the recent developments in automated tools, smaller and cheaper machines for lung ultrasound (LUS) are leading us toward the potential to conduct POCUS tele-guidance for the early detection of pulmonary congestion. This study aims to evaluate the feasibility and accuracy of a self-l...

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Autores principales: Schneider, Eyal, Maimon, Netta, Hasidim, Ariel, Shnaider, Alla, Migliozzi, Gabrielle, Haviv, Yosef S., Halpern, Dor, Abu Ganem, Basel, Fuchs, Lior
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253885/
https://www.ncbi.nlm.nih.gov/pubmed/37298024
http://dx.doi.org/10.3390/jcm12113829
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author Schneider, Eyal
Maimon, Netta
Hasidim, Ariel
Shnaider, Alla
Migliozzi, Gabrielle
Haviv, Yosef S.
Halpern, Dor
Abu Ganem, Basel
Fuchs, Lior
author_facet Schneider, Eyal
Maimon, Netta
Hasidim, Ariel
Shnaider, Alla
Migliozzi, Gabrielle
Haviv, Yosef S.
Halpern, Dor
Abu Ganem, Basel
Fuchs, Lior
author_sort Schneider, Eyal
collection PubMed
description Background: With the recent developments in automated tools, smaller and cheaper machines for lung ultrasound (LUS) are leading us toward the potential to conduct POCUS tele-guidance for the early detection of pulmonary congestion. This study aims to evaluate the feasibility and accuracy of a self-lung ultrasound study conducted by hemodialysis (HD) patients to detect pulmonary congestion, with and without artificial intelligence (AI)-based automatic tools. Methods: This prospective pilot study was conducted between November 2020 and September 2021. Nineteen chronic HD patients were enrolled in the Soroka University Medical Center (SUMC) Dialysis Clinic. First, we examined the patient’s ability to obtain a self-lung US. Then, we used interrater reliability (IRR) to compare the self-detection results reported by the patients to the observation of POCUS experts and an ultrasound (US) machine with an AI-based automatic B-line counting tool. All the videos were reviewed by a specialist blinded to the performer. We examined their agreement degree using the weighted Cohen’s kappa (Kw) index. Results: A total of 19 patients were included in our analysis. We found moderate to substantial agreement between the POCUS expert review and the automatic counting both when the patient performed the LUS (Kw = 0.49 [95% CI: 0.05–0.93]) and when the researcher performed it (Kw = 0.67 [95% CI: 0.67–0.67]). Patients were able to place the probe in the correct position and present a lung image well even weeks from the teaching session, but did not show good abilities in correctly saving or counting B-lines compared to an expert or an automatic counting tool. Conclusions: Our results suggest that LUS self-monitoring for pulmonary congestion can be a reliable option if the patient’s count is combined with an AI application for the B-line count. This study provides insight into the possibility of utilizing home US devices to detect pulmonary congestion, enabling patients to have a more active role in their health care.
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spelling pubmed-102538852023-06-10 Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound? Schneider, Eyal Maimon, Netta Hasidim, Ariel Shnaider, Alla Migliozzi, Gabrielle Haviv, Yosef S. Halpern, Dor Abu Ganem, Basel Fuchs, Lior J Clin Med Article Background: With the recent developments in automated tools, smaller and cheaper machines for lung ultrasound (LUS) are leading us toward the potential to conduct POCUS tele-guidance for the early detection of pulmonary congestion. This study aims to evaluate the feasibility and accuracy of a self-lung ultrasound study conducted by hemodialysis (HD) patients to detect pulmonary congestion, with and without artificial intelligence (AI)-based automatic tools. Methods: This prospective pilot study was conducted between November 2020 and September 2021. Nineteen chronic HD patients were enrolled in the Soroka University Medical Center (SUMC) Dialysis Clinic. First, we examined the patient’s ability to obtain a self-lung US. Then, we used interrater reliability (IRR) to compare the self-detection results reported by the patients to the observation of POCUS experts and an ultrasound (US) machine with an AI-based automatic B-line counting tool. All the videos were reviewed by a specialist blinded to the performer. We examined their agreement degree using the weighted Cohen’s kappa (Kw) index. Results: A total of 19 patients were included in our analysis. We found moderate to substantial agreement between the POCUS expert review and the automatic counting both when the patient performed the LUS (Kw = 0.49 [95% CI: 0.05–0.93]) and when the researcher performed it (Kw = 0.67 [95% CI: 0.67–0.67]). Patients were able to place the probe in the correct position and present a lung image well even weeks from the teaching session, but did not show good abilities in correctly saving or counting B-lines compared to an expert or an automatic counting tool. Conclusions: Our results suggest that LUS self-monitoring for pulmonary congestion can be a reliable option if the patient’s count is combined with an AI application for the B-line count. This study provides insight into the possibility of utilizing home US devices to detect pulmonary congestion, enabling patients to have a more active role in their health care. MDPI 2023-06-02 /pmc/articles/PMC10253885/ /pubmed/37298024 http://dx.doi.org/10.3390/jcm12113829 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schneider, Eyal
Maimon, Netta
Hasidim, Ariel
Shnaider, Alla
Migliozzi, Gabrielle
Haviv, Yosef S.
Halpern, Dor
Abu Ganem, Basel
Fuchs, Lior
Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?
title Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?
title_full Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?
title_fullStr Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?
title_full_unstemmed Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?
title_short Can Dialysis Patients Identify and Diagnose Pulmonary Congestion Using Self-Lung Ultrasound?
title_sort can dialysis patients identify and diagnose pulmonary congestion using self-lung ultrasound?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253885/
https://www.ncbi.nlm.nih.gov/pubmed/37298024
http://dx.doi.org/10.3390/jcm12113829
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