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. 2025 Jun 1;17(6):e85203.
doi: 10.7759/cureus.85203. eCollection 2025 Jun.

Patient Self-Scanning for Lung Ultrasound: A Prospective Observational Study on the Feasibility and Diagnostic Accuracy of a Telemedicine Protocol

Katharine T Clark  1 , Kathleen McFadden  2 , Benjamin A Krauss  3 , Lachlan Driver  1 , Irene W Ma  4   5 , Rachel Vivian  4 , Jamie Gullikson  4 , Lauren Selame  6 , Calvin K Huang  4 , Andrew S Liteplo  1   4 , Hamid Shokoohi  4
Affiliations

Patient Self-Scanning for Lung Ultrasound: A Prospective Observational Study on the Feasibility and Diagnostic Accuracy of a Telemedicine Protocol

Katharine T Clark et al. Cureus. .

Abstract

Objective: To evaluate the feasibility and diagnostic accuracy of patient-performed lung ultrasound (P-PLUS) for telemedicine purposes.

Methods: This prospective observation study included patients over 18 years old who presented to a tertiary care hospital's emergency department. Patients were provided a five-minute instructional video on a US protocol of four lung zones and then performed the protocol while being monitored by a study investigator. The physician sonographer subsequently repeated the protocol. Two emergency physicians with US fellowship training blindly reviewed and independently rated image quality on a scale of one to five, with a score of three or more considered interpretable. Inter-rater reliability was estimated using the intraclass correlation coefficient. Wilcoxon-Mann-Whitney tests and chi-square tests were used to compare group differences.

Results: A total of 56 patients (45% female) were enrolled, and 417 clips were analyzed. Ten (18%) participants worked in the medical field, and 44 (79%) had at least some college education. Forty (71%) regularly used technology at work, 52 (93%) had internet access at home, and the same number had access to smartphones. Patients reported high comfort in performing self-LUS (median score: 4, interquartile range (IQR): 3.5-5) and high willingness to perform US acquisition again in the future (median score: 4, IQR: 4-5). The proportion of interpretable images was similar between the two groups except for the left hemidiaphragm (90% of provider-obtained images were interpretable vs. 45% of patient-obtained images, P = 0.002). The majority of patient-obtained images were scored between three and four and classified as interpretable. Mean image scores were significantly higher for provider-obtained images (P < 0.05). Inter-rater reliability between the two raters was good (intraclass correlation coefficient (ICC)= 0.80, 95% CI 0.76-0.84).

Conclusion: Patients can independently obtain interpretable LUS images in all views with minimal video-based instruction. The ability of patients to obtain interpretable LUS images with minimal tele-guidance, as well as their high levels of comfort and willingness to perform the procedure, support the potential use of P-PLUS in home-based and remote patient care.

Keywords: lung ultrasound (lus); patient-performed lung ultrasound (p-plus); remote patient monitoring; self-performed ultrasound; tele-ultrasound; telemedicine.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Review Board (IRB) of Mass General Brigham issued approval (2020P002611). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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