Abdominal Diseases
Conditions
Keywords
Handheld ultrasound, Abdominal diseases, Gastrointestinal and hepatology consultation, In-patient, Hospita length of stay
Brief summary
The goal of this study is to investigate the impact of integrating handheld abdominal ultrasound into the current gastroenterology and hepatology consultation model at our hospital, particularly in terms of the speed of diagnostic evaluation and the impact of hospital length of stay.
Detailed description
The utilization of handheld ultrasound in the diagnosis and treatment of acute diseases has been practiced for many years, and in certain scenarios, its efficacy is comparable to that of traditional ultrasound. The portability and real-time bedside application of handheld ultrasound have made it increasingly significant in the clinical practice of subspecialties such as cardiovascular, thoracic, and hepato- gastroenterology. Consequently, the use of handheld ultrasound during hospitalizations or emergencies may shorten the time required for accurate diagnosis, enabling patients to receive timely treatment. To investigate the impact of integrating handheld abdominal ultrasound into the current gastroenterology and hepatology consultation model at our hospital, particularly in terms of the speed of diagnostic evaluation and the commencement of treatment. This study employs a prospective design with an anticipated enrollment of 200 patients over approximately one year (December 2024 to November 2025). A clustered-randomized controlled trial design will be used to fit real-world clinical scenario, with participants allocated to either an intervention group (current consultation model supplemented with handheld ultrasound) or a control group by odd/even-numbered calendar days. The primary outcome will be the speed of diagnostic imaging between the two groups. Secondary outcomes will include other indicators of inpatient care quality, such as length of hospital stay and diagnostic accuracy.
Interventions
DIAGNOSTIC_TESTPortable Ultrasound
A handheld portable ultrasound sponsored by Aco Healthcare Co., Ltd company
Sponsors
National Taiwan University Hospital
Aco Healthcare Co., Ltd.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- Patients aged over 18 who are hospitalized and requiring for a gastroenterology consultation or abdominal ultrasound, including cases of abdominal pain, diarrhea, abnormal liver function, unexplained fever, or evaluating intra-abdominal lesions.
Exclusion criteria
* Patients unable to comply with handheld ultrasound examination. * Patients who are in the intensive care unit. * Patients who had already undergone formal abdominal imaging within one week prior to the consultation. * Patients who referred for immediate endoscopic intervention, such as active gastrointestinal bleeding or foreign body ingestion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to diagnostic imaging | From the initiation of the consultation to the execution of the diagnostic imaging study, assessed up to hospital discharge (an average of 14 to 30 days). | This outcome evaluates the clinical efficiency of the diagnostic workflow by measuring the time interval (in minutes) required to complete the initial diagnostic imaging. The exact measurement endpoints are defined by the study arm: Start point (Both arms): The exact time the gastroenterology consultation is initiated. End point (Intervention group): Defined as the interval from the consultation request to the first modality that established the correct diagnosis of the targeted organs matching the final electronic medical record. If the bedside POCUS findings accurately identified the primary pathology, the POCUS timestamp was used; otherwise, the timestamp of the subsequent formal radiology report was utilized. End point (Control group): The execution of the first formally scheduled diagnostic imaging study (e.g., computed tomography \[CT\], magnetic resonance imaging \[MRI\], or conventional cart-based ultrasound) ordered as part of standard care following the consultation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-Consultation Hospital Length of Stay (LOS) | From the initiation of the gastroenterology consultation to the date of hospital discharge, assessed up to a maximum of 1 year. | This outcome evaluates the impact of the intervention on overall hospital resource utilization by measuring the post-consultation length of stay. The post-consultation LOS is defined as the time interval (measured in days) starting from the exact date the gastroenterology consultation is initiated (baseline) to the date the patient is officially discharged from the hospital. Data will be collected for both the intervention group (HUD) and the control group (standard care). Group differences will be analyzed to determine if the expedited point-of-care diagnostic workflow associated with the intervention effectively reduces the remaining hospitalization days. To account for skewed clinical data, comparisons will be reported using median days with interquartile ranges (IQR) and adjusted rate ratios. |
| Diagnostic Accuracy of the Targeted Organ by Handheld Ultrasound Device (HUD) | From the time of initial HUD evaluation up to hospital discharge (an average of 2 to 4 weeks). | This outcome evaluates the diagnostic accuracy of the initial point-of-care evaluation using a HUD. Accuracy is determined by comparing HUD findings (Index Test) against the final definitive diagnosis (Reference Standard). Index Test: The primary pathology recorded by the consultant immediately following the bedside HUD examination. Reference Standard: The final clinical diagnosis of the targeted organ (e.g., biliary tract, liver, pancreas) established prior to discharge. This is confirmed by subsequent formal imaging (e.g., comprehensive ultrasound, CT, MRI). Accuracy is reported as the percentage of HUD evaluations correctly matching the reference standard. |
Countries
Taiwan
Outcome results
None listed