Does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up study
Background The use of point-of-care ultrasound (POCUS) in general practice increases, but little is known about potential unintended findings and harms to patients. Information regarding such unwanted effects may be obtained by evaluating the medical records of patients who have been scanned by thei...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-07-01
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| Series: | Scandinavian Journal of Primary Health Care |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02813432.2025.2487095 |
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| author | Camilla Aakjær Andersen John Brandt Brodersen Jan Mainz Janus Laust Thomsen Ole Graumann Thomas Løkkegaard Martin Bach Jensen |
| author_facet | Camilla Aakjær Andersen John Brandt Brodersen Jan Mainz Janus Laust Thomsen Ole Graumann Thomas Løkkegaard Martin Bach Jensen |
| author_sort | Camilla Aakjær Andersen |
| collection | DOAJ |
| description | Background The use of point-of-care ultrasound (POCUS) in general practice increases, but little is known about potential unintended findings and harms to patients. Information regarding such unwanted effects may be obtained by evaluating the medical records of patients who have been scanned by their general practitioner.Objective To identify and characterize re-consultations related to POCUS use in general practice, potential misdiagnosis, overdiagnosis, and incidental findings, and to compare potentially troublesome cases to GPs’ scanning competence and type of ultrasound device.Design and Setting Professors in general practice with extensive experience in both research and quality assurance in general practice did a blinded review of prospectively collected routine electronic medical record data combined with cross-sectional data collected in relation to POCUS examinations.Subjects Twenty general practitioners collected data on 564 patients examined with POCUS in primary care.Main Outcome Measures International standards for the classification of adverse events and incidental findings were used. First, research assistants identified all re-consultations described in the medical records that were related to the primary health complaint at the index consultation. Second, these re-consultations were classified by the medical experts in terms of seriousness and relation to the POCUS examination performed at the index consultation. In addition, the experts identified possible misdiagnosis, possible overdiagnosis, and incidental findings. Finally, identified cases were discussed in terms of appropriateness and described narratively.Results Medical records of 564 patients were reviewed. A low risk of possible misdiagnosis (5.3%), potential overdiagnosis (0.7%), and incidental findings (0.7%) were found. Eleven POCUS-related re-consultations were identified and described.Conclusion POCUS scanning performed by general practitioners was generally safe, but it can result in unnecessary examinations and potential harm in a few cases. Certain areas, e.g. pelvic scans that included the ovaries, may especially be prone to misdiagnosis.Trial Registration Number NCT03375333 |
| format | Article |
| id | doaj-art-407e7ec944e546ab89fd68bd7a6bdaf4 |
| institution | Kabale University |
| issn | 0281-3432 1502-7724 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Scandinavian Journal of Primary Health Care |
| spelling | doaj-art-407e7ec944e546ab89fd68bd7a6bdaf42025-08-23T12:51:57ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242025-07-0143361362510.1080/02813432.2025.2487095Does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up studyCamilla Aakjær Andersen0John Brandt Brodersen1Jan Mainz2Janus Laust Thomsen3Ole Graumann4Thomas Løkkegaard5Martin Bach Jensen6Center for General Practice at Aalborg University, Aalborg, DenmarkCentre of General Practice, Department of Public Health, Faculty of Health Sciences, University of CopenhagenDanish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, DenmarkCenter for General Practice at Aalborg University, Aalborg, DenmarkDepartment of Radiology, Aarhus University Hospital, DenmarkCenter for General Practice at Aalborg University, Aalborg, DenmarkCenter for General Practice at Aalborg University, Aalborg, DenmarkBackground The use of point-of-care ultrasound (POCUS) in general practice increases, but little is known about potential unintended findings and harms to patients. Information regarding such unwanted effects may be obtained by evaluating the medical records of patients who have been scanned by their general practitioner.Objective To identify and characterize re-consultations related to POCUS use in general practice, potential misdiagnosis, overdiagnosis, and incidental findings, and to compare potentially troublesome cases to GPs’ scanning competence and type of ultrasound device.Design and Setting Professors in general practice with extensive experience in both research and quality assurance in general practice did a blinded review of prospectively collected routine electronic medical record data combined with cross-sectional data collected in relation to POCUS examinations.Subjects Twenty general practitioners collected data on 564 patients examined with POCUS in primary care.Main Outcome Measures International standards for the classification of adverse events and incidental findings were used. First, research assistants identified all re-consultations described in the medical records that were related to the primary health complaint at the index consultation. Second, these re-consultations were classified by the medical experts in terms of seriousness and relation to the POCUS examination performed at the index consultation. In addition, the experts identified possible misdiagnosis, possible overdiagnosis, and incidental findings. Finally, identified cases were discussed in terms of appropriateness and described narratively.Results Medical records of 564 patients were reviewed. A low risk of possible misdiagnosis (5.3%), potential overdiagnosis (0.7%), and incidental findings (0.7%) were found. Eleven POCUS-related re-consultations were identified and described.Conclusion POCUS scanning performed by general practitioners was generally safe, but it can result in unnecessary examinations and potential harm in a few cases. Certain areas, e.g. pelvic scans that included the ovaries, may especially be prone to misdiagnosis.Trial Registration Number NCT03375333https://www.tandfonline.com/doi/10.1080/02813432.2025.2487095Ultrasonographyprimary carequality assurancegeneral practiceadverse effects |
| spellingShingle | Camilla Aakjær Andersen John Brandt Brodersen Jan Mainz Janus Laust Thomsen Ole Graumann Thomas Løkkegaard Martin Bach Jensen Does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up study Scandinavian Journal of Primary Health Care Ultrasonography primary care quality assurance general practice adverse effects |
| title | Does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up study |
| title_full | Does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up study |
| title_fullStr | Does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up study |
| title_full_unstemmed | Does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up study |
| title_short | Does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up study |
| title_sort | does point of care ultrasound examination by the general practitioner lead to inappropriate care a follow up study |
| topic | Ultrasonography primary care quality assurance general practice adverse effects |
| url | https://www.tandfonline.com/doi/10.1080/02813432.2025.2487095 |
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