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Observational Study
. 2025 Apr 8;26(1):99.
doi: 10.1186/s12875-025-02802-4.

Accuracy of point-of-care ultrasound examination of the lung in primary care performed by general practitioners: a cross-sectional study

Affiliations
Observational Study

Accuracy of point-of-care ultrasound examination of the lung in primary care performed by general practitioners: a cross-sectional study

David Halata et al. BMC Prim Care. .

Abstract

Background: Lung ultrasonography (LUS) is a point-of-care imaging modality with growing potential in primary care.

Objectives: While its use is well established in hospital settings, data on its accuracy when performed by general practitioners (GPs) remain limited. This study aimed to assess the diagnostic accuracy of LUS conducted by GPs following structured training.

Methods: We recruited 17 GPs from various regions of the Czech Republic. They completed a two-day educational course focused on LUS. Patients with current dyspnoea (NYHA II-IV) or a history of dyspnoea within the last four weeks were included and underwent LUS to assess the presence of pleural effusion and interstitial syndrome. An independent expert sonographer, blinded to clinical data, evaluated recorded LUS video loops as the reference standard. LUS findings were categorized into A profile (presence of A lines and intact lung sliding, indicating normal aeration), B profile (three or more B lines per intercostal space in at least two intercostal spaces per hemithorax, suggesting interstitial syndrome), pulmonary consolidation and pleural effusion.

Results: A total of 128 patients were enrolled in the study. A total of 768 thoracic segments were examined. A profile was identified in 642 (83.6%) segments, B profile in 108 (14.1%), pulmonary consolidation in 8 (1.0%), and pleural effusion in 12 (1.6%). For the identification of A profile, the sensitivity was 97.51% (95% CI 95.98-98.57), and the specificity was 88.10% (95% CI 81,13-93,18); for B profile, the sensitivity was 87.04% (95% CI 79,21-92,73), and the specificity was 97.73% (95% CI96,28-98,72); for pulmonary consolidation, the sensitivity was 100.0% (95% CI 63,06-100,00), and the specificity was 100.0% (95% CI 99,52-100,0); for pleural effusion, the sensitivity was 83.33% (95% CI 51,59-97,91), and the specificity was 99.87% (95% CI 99,27-100,00).

Conclusion: Our findings provide important preliminary data, demonstrating that GPs can perform LUS accurately after a structured training program. THE TRIAL REGISTRATION IDENTIFIER: is NCT04905719.

Keywords: Accuracy; COVID-19; Lung examination; Point-of-care ultrasound; Primary care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study received ethical approval from the Institutional Ethics Committee of the University Hospital Hradec Králové on May 25, 2021, with reference number 202106 P10. The study was conducted in accordance with the Declaration of Helsinki and relevant national regulations. Patient inclusion in the study required informed consent to participate in the clinical study. All participants provided informed consent prior to their involvement. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Structured recording form for lung POCUS examination according to the BLUE protocol (bedside lung ultrasound in emergency) used in the study
Fig. 2
Fig. 2
Representative images of various lung ultrasound patterns considered in this study and their descriptions
Fig. 3
Fig. 3
Flow chart documenting participants included in the study

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