International Evidence-Based Recommendations for Focused Cardiac Ultrasound.
Via, Gabriele MD a,*; Hussain, Arif MD b; Wells, Mike MD, BSc, BSc Hons, MBBCh, FCEM, Dip PEC c; Reardon, Robert MD d; ElBarbary, Mahmoud MD e; Noble, Vicki E. MD f; Tsung, James W. MD, MPH g,h; Neskovic, Aleksandar N. MD, PhD, FESC, FACC i; Price, Susanna MD, MBBS, BSc, MRCP, EDICM, PhD, FFICM, FESC j; Oren-Grinberg, Achikam MD, MS k; Liteplo, Andrew MD, RDMS l; Cordioli, Ricardo MD m; Naqvi, Nitha MD, MSc, MRCPCH n; Rola, Philippe MD o; Poelaert, Jan MD, PhD p; Gulic, Tatjana Golob MD q; Sloth, Erik MD, PhD, DMSc r; Labovitz, Arthur MD, FACC s; Kimura, Bruce MD, FACC t; Breitkreutz, Raoul MD u; Masani, Navroz MBBS, FRCP v; Bowra, Justin FACEM, CCPU w; Talmor, Daniel MD, MPH k; Guarracino, Fabio MD x; Goudie, Adrian BMedSci(Hons), MBBS, FACEM DDU y; Xiaoting, Wang MD z; Chawla, Rajesh MD, FCCM aa; Galderisi, Maurizio MD bb; Blaivas, Micheal MD, FACEP, FAIUM cc; Petrovic, Tomislav MD dd; Storti, Enrico MD ee; Neri, Luca MD ff; Melniker, Lawrence MD, MS gg,hh; International Liaison Committee on Focused Cardiac UltraSound (ILC-FoCUS); for the International Conference on Focused Cardiac UltraSound (IC-FoCUS)
[Article]
Journal of the American Society of Echocardiography.
27(7):683e1-683e33, July 2014.
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Background: Focused cardiac ultrasound (FoCUS) is a simplified, clinician-performed application of echocardiography that is rapidly expanding in use, especially in emergency and critical care medicine. Performed by appropriately trained clinicians, typically not cardiologists, FoCUS ascertains the essential information needed in critical scenarios for time-sensitive clinical decision making. A need exists for quality evidence-based review and clinical recommendations on its use.
Methods: The World Interactive Network Focused on Critical UltraSound conducted an international, multispecialty, evidence-based, methodologically rigorous consensus process on FoCUS. Thirty-three experts from 16 countries were involved. A systematic multiple-database, double-track literature search (January 1980 to September 2013) was performed. The Grading of Recommendation, Assessment, Development and Evaluation method was used to determine the quality of available evidence and subsequent development of the recommendations. Evidence-based panel judgment and consensus was collected and analyzed by means of the RAND appropriateness method.
Results: During four conferences (in New Delhi, Milan, Boston, and Barcelona), 108 statements were elaborated and discussed. Face-to-face debates were held in two rounds using the modified Delphi technique. Disagreement occurred for 10 statements. Weak or conditional recommendations were made for two statements and strong or very strong recommendations for 96. These recommendations delineate the nature, applications, technique, potential benefits, clinical integration, education, and certification principles for FoCUS, both for adults and pediatric patients.
Conclusions: This document presents the results of the first International Conference on FoCUS. For the first time, evidence-based clinical recommendations comprehensively address this branch of point-of-care ultrasound, providing a framework for FoCUS to standardize its application in different clinical settings around the world.
(C) 2014Elsevier, Inc.
