Remote ultrasound training helps physicians in resource-strapped areas diagnose TB
A group of medical practitioners in Malawi, a country in east Africa, used ultrasound to diagnose tuberculosis (TB) in patients with HIV with the aid of a tele-ultrasonography platform that sent images to U.S-based radiologists, reported authors of a recent Journal of the American College of Radiology study.
Lead author Kristin Schwab, MD, with University of California, Los Angeles, and colleagues believe the technique could bring affordable, easy-to-perform care to resource-strapped regions.
“This study…has the potential not only to improve the diagnosis of extrapulmonary TB in the global health setting, but also to inspire the creation of future protocols using tele-ultrasonography to harness radiology expertise for training in resource limited settings,” Schwab and colleagues wrote.
Eleven participants were trained over four days and performed scans on 183 patients. Seven were clinical officers, two physicians, one a radiographer and another a medical assistant—none had reported previous experience with ultrasound to diagnose TB. A total of 75 scans were performed on HIV-positive patients without TB and 108 on TB cases.
An expert radiologist served as the standard of reference and identified 85 (five percent) abnormal images. The clinicians selected 96 (six percent) of the abnormal images—an overall agreement rate of 98 percent between the two groups.
“Our prospective observational study suggests that both physician and non-physician clinicians can learn the technical skills of ultrasound image acquisition after a short four-day training course followed by focused tele ultrasonography feedback,” the authors concluded.