Original Title: Brugen af håndholdte pocket-sized ultralydsscannere til point-of-care undersøgelser af patienter i akutmodtagelsen

Authors' objectives: Handheld ultrasound devices for point-of-care examination in emergency departments shows potential benefits such as increased accessibility, faster utilization, and lower acquisition costs compared to non-handheld ultrasound scanners. With a growing use of focused ultrasound in emergency medicine, the Danish Health Technology Council seeks to investigate the effects and consequences of the technology by clarifying the diagnostic accuracy, organizational implications, and potential health economic savings.

Authors' results and conclusions: The Expert Committee concludes that based on sensitivity across studies and included target diagnoses, there is a tendency for HHUSD to be inferior to non-handheld ultrasound scanners. The literature indicates a potential risk of false-negative findings when using HHUSD compared to non-handheld ultrasound scanners. However, the literature suggests that HHUSD, assessed for specificity, is non-inferior or nearly non-inferior to non-handheld ultrasound scanners, indicating no risk of false-positive findings. The Expert Committee notes that the literature is generally outdated, based on older versions of HHUSD, and the methodological heterogeneity of the studies prevents a conclusive summary based on the literature. Regarding patient perspectives, The Expert Committee concludes that it has not been possible to identify relevant literature in the systematic literature search to answer the research question. The Expert Committee assesses that patient considerations and preferences do not influence the use of HHUSD compared to non-handheld ultrasound scanners but that ultrasound examinations in general can enhance the dialogue between doctor and patient. The Expert Committee concludes that HHUSD is partially implemented in Danish emergency departments (11 out of 21 departments). There are no significant differences in workflow and time consumption when comparing HHUSD and non-handheld ultrasound scanners. However, scanner availability in each emergency department is essential in assessing the value of HHUSD. HHUSD is described as particularly advantageous for isolated patients due to hygiene concerns. Among emergency department physicians, there are significantly different attitudes and preferences towards HHUSD where some find it useful and others find it too unreliable. The Committee assesses that local conditions and individual physician assessments and preferences are crucial for determining whether HHUSD can be considered a valuable supplement to existing ultrasound devices. The Expert Committee concludes that the cost analysis estimates HHUSD to be less costly per use compared to non-handheld scanners. The lifespan of the device affects the extent of potential savings with HHUSD. However, simultaneous use of both scanners with increased time consumption changes the result of the analysis resulting in HHUSD being more costly than non-handheld scanners. Yet, potential time savings with HHUSD result in an even greater cost advantage. The Committee notes that the included inputs are highly operator- and location-dependent, with considerable uncertainty in population size. Therefore, the results neither support nor oppose the use of HHUSD.

Project Status: Completed

URL for project: https://behandlingsraadet.dk/find-evalueringer-analyser/analyser/2021/handholdt-fokuseret-ultralyd-i-akutte-patientforlob

Year Published: 2023

URL for published report: https://behandlingsraadet-classic.azureedge.net/media/ustn1yki/recommendation.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Denmark

Organisation Name: The Danish Health Technology Council

Contact Address: Niels Jernes Vej 6a, 9220 Aalborg

Contact Name: Nikolaj Hellmuth Skak

Contact Email: nsp@behandlingsraadet.dk