Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea—Protocol for A Randomized Controlled Trial

Stig Holm Ovesen; Søren Helbo Skaarup; Rasmus Aagaard; Hans Kirkegaard; Bo Løfgren; Michael Dan Arvig; Bo Martin Bibby; Stefan Posth; Christian B. Laursen; Jesper Weile

doi:10.2147/OAEM.S454062

Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea—Protocol for A Randomized Controlled Trial

Stig Holm Ovesen^*, Søren Helbo Skaarup, Rasmus Aagaard, Hans Kirkegaard, Bo Løfgren, Michael Dan Arvig, Bo Martin Bibby, Stefan Posth, Christian B. Laursen, Jesper Weile

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Purpose: Point-of-care ultrasound (POCUS) helps emergency department (ED) physicians make prompt and appropriate decisions, but the optimal diagnostic integration and potential clinical benefits remain unclear. We describe the protocol and statistical analysis plan for a randomized controlled trial. The objective is to determine the effect of a POCUS-driven diagnostic pathway in adult dyspneic ED patients on the proportion of patients having a hospital stay of less than 24 hours when compared to the standard diagnostic pathway. Patients and Methods: This is a multicenter, randomized, investigator-initiated, open-labeled, pragmatic, controlled trial. Adult ED patients with chief complaint dyspnea are eligible. Patients are randomized (1:1) to the POCUS-driven diagnostic pathway or standard diagnostic pathway, with 337 patients in each group. The primary outcome is the proportion of patients having a hospital stay (from ED arrival to hospital discharge) of less than 24 hours. Key secondary outcomes include hospital length-of-stay, 72-hour revisits, and 30-day hospital-free days. Conclusion: Sparse evidence exists for any clinical benefit from a POCUS-integrated diagnostic pathway. The results from this trial will help clarify the promising signals for POCUS to influence patient care among ED patients with dyspnea.

Original language	English
Journal	Open Access Emergency Medicine
Volume	16
Pages (from-to)	211-219
Number of pages	9
ISSN	1179-1500
DOIs	https://doi.org/10.2147/OAEM.S454062
Publication status	Published - 2024

Keywords

diagnostic effectiveness
focused cardiac ultrasound
focused lung ultrasound
shortness-of-breath

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Ovesen, S. H., Skaarup, S. H., Aagaard, R., Kirkegaard, H., Løfgren, B., Arvig, M. D., Bibby, B. M., Posth, S., Laursen, C. B., & Weile, J. (2024). Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea—Protocol for A Randomized Controlled Trial. Open Access Emergency Medicine, 16, 211-219. https://doi.org/10.2147/OAEM.S454062

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title = "Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea—Protocol for A Randomized Controlled Trial",

abstract = "Purpose: Point-of-care ultrasound (POCUS) helps emergency department (ED) physicians make prompt and appropriate decisions, but the optimal diagnostic integration and potential clinical benefits remain unclear. We describe the protocol and statistical analysis plan for a randomized controlled trial. The objective is to determine the effect of a POCUS-driven diagnostic pathway in adult dyspneic ED patients on the proportion of patients having a hospital stay of less than 24 hours when compared to the standard diagnostic pathway. Patients and Methods: This is a multicenter, randomized, investigator-initiated, open-labeled, pragmatic, controlled trial. Adult ED patients with chief complaint dyspnea are eligible. Patients are randomized (1:1) to the POCUS-driven diagnostic pathway or standard diagnostic pathway, with 337 patients in each group. The primary outcome is the proportion of patients having a hospital stay (from ED arrival to hospital discharge) of less than 24 hours. Key secondary outcomes include hospital length-of-stay, 72-hour revisits, and 30-day hospital-free days. Conclusion: Sparse evidence exists for any clinical benefit from a POCUS-integrated diagnostic pathway. The results from this trial will help clarify the promising signals for POCUS to influence patient care among ED patients with dyspnea.",

keywords = "diagnostic effectiveness, focused cardiac ultrasound, focused lung ultrasound, shortness-of-breath",

author = "Ovesen, {Stig Holm} and Skaarup, {S{\o}ren Helbo} and Rasmus Aagaard and Hans Kirkegaard and Bo L{\o}fgren and Arvig, {Michael Dan} and Bibby, {Bo Martin} and Stefan Posth and Laursen, {Christian B.} and Jesper Weile",

note = "Publisher Copyright: {\textcopyright} 2024 Ovesen et al.",

year = "2024",

doi = "10.2147/OAEM.S454062",

language = "English",

volume = "16",

pages = "211--219",

journal = "Open Access Emergency Medicine",

issn = "1179-1500",

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Ovesen, SH , Skaarup, SH , Aagaard, R , Kirkegaard, H , Løfgren, B, Arvig, MD, Bibby, BM, Posth, S, Laursen, CB & Weile, J 2024, 'Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea—Protocol for A Randomized Controlled Trial', Open Access Emergency Medicine, vol. 16, pp. 211-219. https://doi.org/10.2147/OAEM.S454062

Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea—Protocol for A Randomized Controlled Trial. / Ovesen, Stig Holm ; Skaarup, Søren Helbo ; Aagaard, Rasmus et al.
In: Open Access Emergency Medicine, Vol. 16, 2024, p. 211-219.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea—Protocol for A Randomized Controlled Trial

AU - Ovesen, Stig Holm

AU - Skaarup, Søren Helbo

AU - Aagaard, Rasmus

AU - Kirkegaard, Hans

AU - Løfgren, Bo

AU - Arvig, Michael Dan

AU - Bibby, Bo Martin

AU - Posth, Stefan

AU - Laursen, Christian B.

AU - Weile, Jesper

PY - 2024

Y1 - 2024

N2 - Purpose: Point-of-care ultrasound (POCUS) helps emergency department (ED) physicians make prompt and appropriate decisions, but the optimal diagnostic integration and potential clinical benefits remain unclear. We describe the protocol and statistical analysis plan for a randomized controlled trial. The objective is to determine the effect of a POCUS-driven diagnostic pathway in adult dyspneic ED patients on the proportion of patients having a hospital stay of less than 24 hours when compared to the standard diagnostic pathway. Patients and Methods: This is a multicenter, randomized, investigator-initiated, open-labeled, pragmatic, controlled trial. Adult ED patients with chief complaint dyspnea are eligible. Patients are randomized (1:1) to the POCUS-driven diagnostic pathway or standard diagnostic pathway, with 337 patients in each group. The primary outcome is the proportion of patients having a hospital stay (from ED arrival to hospital discharge) of less than 24 hours. Key secondary outcomes include hospital length-of-stay, 72-hour revisits, and 30-day hospital-free days. Conclusion: Sparse evidence exists for any clinical benefit from a POCUS-integrated diagnostic pathway. The results from this trial will help clarify the promising signals for POCUS to influence patient care among ED patients with dyspnea.

AB - Purpose: Point-of-care ultrasound (POCUS) helps emergency department (ED) physicians make prompt and appropriate decisions, but the optimal diagnostic integration and potential clinical benefits remain unclear. We describe the protocol and statistical analysis plan for a randomized controlled trial. The objective is to determine the effect of a POCUS-driven diagnostic pathway in adult dyspneic ED patients on the proportion of patients having a hospital stay of less than 24 hours when compared to the standard diagnostic pathway. Patients and Methods: This is a multicenter, randomized, investigator-initiated, open-labeled, pragmatic, controlled trial. Adult ED patients with chief complaint dyspnea are eligible. Patients are randomized (1:1) to the POCUS-driven diagnostic pathway or standard diagnostic pathway, with 337 patients in each group. The primary outcome is the proportion of patients having a hospital stay (from ED arrival to hospital discharge) of less than 24 hours. Key secondary outcomes include hospital length-of-stay, 72-hour revisits, and 30-day hospital-free days. Conclusion: Sparse evidence exists for any clinical benefit from a POCUS-integrated diagnostic pathway. The results from this trial will help clarify the promising signals for POCUS to influence patient care among ED patients with dyspnea.

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KW - focused cardiac ultrasound

KW - focused lung ultrasound

KW - shortness-of-breath

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U2 - 10.2147/OAEM.S454062

DO - 10.2147/OAEM.S454062

M3 - Journal article

C2 - 39221420

AN - SCOPUS:85203044288

SN - 1179-1500

VL - 16

SP - 211

EP - 219

JO - Open Access Emergency Medicine

JF - Open Access Emergency Medicine

ER -

Effect of a Point-of-Care Ultrasound-Driven vs Standard Diagnostic Pathway on 24-Hour Hospital Stay in Emergency Department Patients with Dyspnea—Protocol for A Randomized Controlled Trial

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Keywords

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