Background: Ultraportable or pocket handheld ultrasound devices (HUD) may be useful for large-scale abdominal aortic aneurysm screening. However, the reproducibility of measurements has not been compared with conventional cart-based ultrasound machines.
Objectives: Investigate the intra- and inter-operator reproducibility of a HUD compared with a conventional ultrasound machine for aortic screening.
Design: Analytical, cross-sectional.
Setting: Ultrasound department at a large tertiary care hospital in Riyadh.
Patients and methods: Eligible male participants aged ≥60 years were invited to participate upon arriving for a non-vascular ultrasound appointment. Three repeated anteroposterior measurements of the transverse aorta were made at the proximal and distal locations for each machine before repeating the measurements on a subset of participants by a second blinded operator. Intraclass correlation coefficients (ICC) and the Bland-Altman method were used to analyze reproducibility.
Main outcome measure: Inter-system and intra- and inter-operator ICCs.
Sample size: 114 males with repeated measurements by second operator on a subset of 35 participants.
Results: The median age (interquartile range) of participants was 68 years (62-74 years). The intra- and inter-operator ICCs were all >0.800 showing almost perfect agreement except for the inter-operator reproducibility at the proximal location using a conventional machine (ICC= 0.583, P=.007) and the Butterfly device (ICC=0.467, P=.037). The inter-system ICCs (95% CI) were 0.818 (0.736-0.874) and 0.879 (0.799-0.924) at the proximal and distal locations, respectively. The mean difference in aortic measurement between the ultrasound systems was 0.3 mm (1.7%) in the proximal location and 0.6 mm (3.6%) in the distal location. In total, >91% of the difference in measurements between the machines was <3 mm. The mean scanning time was 4:16 minutes for the conventional system and 3:53 minutes for the HUD (P=.34).
Conclusions: Abdominal aortic screening using a HUD was feasible and reliable compared with a conventional ultrasound machine. A pocket HUD should be considered for large-scale screening.
Limitations: No cases of abdominal aortic aneurysm in the sample and lack of blinding.
Conflict of interest: None.