RESUMEN
Point-of-care ultrasound (POCUS) is an imaging modality that has become a fundamental part of clinical care provided in the emergency department (ED). The applications of this tool in the ED have ranged from resuscitation, diagnosis, and therapeutic to procedure guidance. This review aims to summarize the evidence on the use of POCUS for diagnosis and procedure guidance. To achieve this, CrossRef, PubMed, Cochrane Library, Web of Science, and Google Scholar databases were extensively searched for studies published between January 2000 and November 2023. Additionally, the risk of bias assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies 2 (for studies on the diagnostic role of POCUS) and Cochrane Risk of Bias tool (for studies on the use of POCUS for procedure guidance). Furthermore, diagnostic accuracy outcomes were pooled using STATA 16 software (StatCorp., College Station, TX, USA), while outcomes related to procedure guidance were pooled using the Review Manager software. The study included 81 articles (74 evaluating the diagnostic application of POCUS and seven evaluating the use of POCUS in guiding clinical procedures). In our findings sensitivities and specificities for various conditions were as follows: appendicitis, 65% and 89%; hydronephrosis, 82% and 74%; small bowel obstruction, 93% and 82%; cholecystitis, 75% and 96%; retinal detachment, 94% and 91%; abscess, 95% and 85%; foreign bodies, 67% and 97%; clavicle fractures, 93% and 94%; distal forearm fractures, 97% and 94%; metacarpal fractures, 94% and 92%; skull fractures, 91% and 97%; and pleural effusion, 91% and 97%. A subgroup analysis of data from 11 studies also showed that the two-point POCUS has a sensitivity and specificity of 89% and 96%, while the three-point POCUS is 87% sensitive and 92% specific in the diagnosis of deep vein thrombosis. In addition, the analyses showed that ultrasound guidance significantly increases the overall success rate of peripheral venous access (p = 0.02) and significantly reduces the number of skin punctures (p = 0.01) compared to conventional methods. In conclusion, POCUS can be used in the ED to diagnose a wide range of clinical conditions accurately. Furthermore, it can be used to guide peripheral venous access and central venous catheter insertion.
RESUMEN
Background and objective Stroke-related deaths have been one of the major causes of death worldwide due to its rising risk factors. As a result, several people rely on YouTube as a great source of information on stroke without knowing the genuineness of the content. This study aims to assess the quality and reliability of the information on stroke uploaded on the YouTube platform using the Global Quality score (GQS) and DISCERN score (DS), respectively. Methodology A cross-sectional observational study was conducted in April 2023. Stroke-related keywords were used to search for videos on YouTube. Videos that met inclusion criteria were evaluated for baseline characteristics (likes, comments, views, duration of video, time since posted, and uploader type) and type of information in the video about stroke (symptoms, etiology, treatment, and other parameters). These videos were then evaluated for quality and reliability of information using GQS and DS, respectively. Results After applying inclusion and exclusion criteria and removing the duplicates, 73 YouTube videos were selected. The videos had a total number of 23,927,445 views, 385,324 likes, and 31,927 comments. Maximum videos were uploaded by hospitals (25, 34.2%). Several videos described the symptoms (54, 73.97%), treatment (50, 68.49%), and etiology (49, 67.12%) of stroke. The reach of videos measured by the Video Power Index (VPI) was highest for videos uploaded by healthcare organizations (mean VPI = 120.11). There was no statistically significant difference (P > 0.05) in the quality (GQS score) and reliability (DS) of videos uploaded by doctors, hospitals, healthcare organizations, and news channels. Conclusions YouTube can become an important source to disseminate information about health-related conditions like stroke if the videos uploaded are of high quality (GQS score) and reliable (DS).