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Title: | Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: Study protocol of a randomized controlled trial - The IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study. | Authors: | Fazio T.;Maier A.B.;Johnson D.;El-Ansary D.;Clarke-Errey S.;Royse C.;Cid X.;Canty D.;Royse A. | Monash Health Department(s): | Anaesthesia and Perioperative Medicine | Institution: | (Cid, Canty, Royse, El-Ansary, Royse) Department of Surgery, University of Melbourne, Melbourne, VIC, Australia (Cid, Maier, Johnson) Department of Medicine and Community Care, Royal Melbourne Hospital, Parkville, VIC, Australia (Canty) Department of Anesthesia and Perioperative Medicine, Monash Health, Melbourne, VIC, Australia (Canty, Royse) Department of Anesthesia and Pain Management, Royal Melbourne Hospital, Parkville, VIC, Australia (Royse) Department of Surgery, Royal Melbourne Hospital, Parkville, VIC, Australia (Maier) Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia (Maier) Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universitet, Amsterdam, Netherlands (El-Ansary) Department of Health Professions, Swinburne University of Technology, Melbourne, VIC, Australia (Clarke-Errey) Statistical Consulting Centre, University of Melbourne, Parkville, VIC, Australia (Fazio) Business Intelligence Unit, Melbourne Health, Parkville, VIC, Australia (Fazio) Department of Medicine and Radiology, Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia (Royse) Outcomes Consortium, Cleveland Clinic, Cleveland, OH, United States | Issue Date: | 29-Jan-2020 | Copyright year: | 2020 | Publisher: | BioMed Central Ltd. (E-mail: info@biomedcentral.com) | Place of publication: | United Kingdom | Publication information: | Trials. 21 (1) (no pagination), 2020. Article Number: 53. Date of Publication: 08 Jan 2020. | Journal: | Trials | Abstract: | Background: Point-of-care ultrasound (POCUS) is emerging as a reliable and valid clinical tool that impacts diagnosis and clinical decision-making as well as timely intervention for optimal patient management. This makes its utility in patients admitted to internal medicine wards attractive. However, there is still an evidence gap in all the medical setting of how its use affects clinical variables such as length of stay, morbidity, and mortality. Methods/design: A prospective randomized controlled trial assessing the effect of a surface POCUS of the heart, lungs, and femoral and popliteal veins performed by an internal medicine physician during the first 24 h of patient admission to the unit with a presumptive cardiopulmonary diagnosis. The University of Melbourne iHeartScan, iLungScan, and two-point venous compression protocols are followed to identify left and right ventricular function, significant valvular heart disease, pericardial and pleural effusion, consolidation, pulmonary edema, pneumothorax, and proximal deep venous thrombosis. Patient management is not commanded by the protocol and is at the discretion of the treating team. A total of 250 patients will be recruited at one tertiary hospital. Participants are randomized to receive POCUS or no POCUS. The primary outcome measured will be hospital length of stay. Secondary outcomes include the change in diagnosis and management, 30-day hospital readmission, and healthcare costs. Discussion(s): This study will evaluate the clinical impact of multi-organ POCUS in internal medicine patients admitted with cardiopulmonary diagnosis on the hospital length of stay. Recruitment of participants commenced in September 2018 and is estimated to be completed by March 2020. Trial registration: Australian and New Zealand Clinical Trial Registry, ACTRN12618001442291. Registered on 28 August 2018.Copyright © 2020 The Author(s). | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1186/s13063-019-4003-2 | PubMed URL: | 31915052 [http://www.ncbi.nlm.nih.gov/pubmed/?term=31915052] | ISSN: | 1745-6215 (electronic) | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/29379 | Type: | Article | Subjects: | controlled study deep vein thrombosis/di [Diagnosis] *echography femoral vein fracture healing/di [Diagnosis] health care cost heart heart left ventricle function heart right ventricle function hospital admission hospital patient hospital readmission human *internal medicine internist *length of stay lung *lung disease/di [Diagnosis] lung edema/di [Diagnosis] major clinical study outcome assessment parallel design pericardial effusion/di [Diagnosis] pleura effusion/di [Diagnosis] pneumothorax/di [Diagnosis] *point of care testing popliteal vein prospective study randomized controlled trial superiority trial tertiary care center valvular heart disease/di [Diagnosis] workflow portable ultrasound scanner article *cardiovascular disease/di [Diagnosis] clinical decision making deep vein thrombosis echography femoral vein fracture healing health care cost heart heart left ventricle function heart right ventricle function hospital admission hospital patient hospital readmission internal medicine internist length of stay lung lung disease lung edema parallel design pericardial effusion pleura effusion pneumothorax point of care testing popliteal vein superiority trial tertiary care center valvular heart disease workflow portable ultrasound scanner cardiovascular disease clinical decision making health care cost heart heart left ventricle function heart right ventricle function hospital admission hospital patient hospital readmission human *internal medicine internist *length of stay lung *lung disease / *diagnosis lung edema / diagnosis major clinical study outcome assessment parallel design pericardial effusion / diagnosis pleura effusion / diagnosis pneumothorax / diagnosis *point of care testing popliteal vein prospective study randomized controlled trial superiority trial tertiary care center workflow valvular heart disease / diagnosis *echography deep vein thrombosis / diagnosis femoral vein clinical decision making *cardiovascular disease / *diagnosis controlled study fracture healing / diagnosis Article |
Type of Clinical Study or Trial: | Randomised controlled trial |
Appears in Collections: | Articles |
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