{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:24:54Z","timestamp":1772987094752,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate which patient characteristics, ultrasound operator certification level, and thoracic ultrasound (TUS) examination findings are associated with a TUS\u2010induced change in clinical management in adult intensive care unit (ICU) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Post hoc analysis of a prospective international observational study (UltraMan study) on the impact of thoracic ultrasound on clinical management of critically ill patients. The first TUS examinations of each patient included in the study were included in this analysis. Multivariable logistic regression was performed to identify which patient characteristic(s), operator certification level, or TUS\u2010related factors were significantly associated with a change in management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>The first TUS examinations of each of the 534 patients were included in this analysis. TUS led to management changes in almost half of the patients in whom a TUS was performed (44.6%). TUS\u2010induced management changes were significantly associated with patient characteristics. Specifically, a medical history of cardiovascular disease demonstrated a significant association (OR: 1.73; 95% CI: 1.12\u20132.68). In terms of TUS examination findings, hypovolemia demonstrated a significant association with a change in management (OR: 2.05; 95% CI: 1.10\u20133.80). No significant association was found between ultrasound operator certification level and changes in management driven by TUS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study indicates that TUS was associated with management changes in 44.6% of ICU patients, with stronger associations in those with cardiovascular disease and hypovolemia, and no detectable effect of operator certification in adjusted analyses. As a post hoc analysis of an observational cohort, these findings warrant cautious interpretation and underscore the importance of competency\u2010based training and quality assurance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70104","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T09:10:19Z","timestamp":1760605819000},"page":"635-641","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thoracic Ultrasound\u2013Related Management Change: Predictors and the Role of Operator Certification (Secondary Analysis of\n                    <scp>UltraMAN<\/scp>\n                    )"],"prefix":"10.1002","volume":"54","author":[{"given":"Jorge E.","family":"Lopez Matta","sequence":"first","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micah L. A.","family":"Heldeweg","sequence":"additional","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Amsterdam University Medical Centers  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Pisani","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Regional General Hospital F. Miulli  Acquaviva delle Fonti metropolitan city of Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos V.","family":"Elzo Kraemer","sequence":"additional","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Slot","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Noordwest Ziekenhuisgroep  Alkmaar the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark E.","family":"Haaksma","sequence":"additional","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Amsterdam University Medical Centers  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasper M.","family":"Smit","sequence":"additional","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Amsterdam University Medical Centers  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amne","family":"Mousa","sequence":"additional","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Amsterdam University Medical Centers  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Magnesa","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Regional General Hospital F. Miulli  Acquaviva delle Fonti metropolitan city of Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizia","family":"Massaro","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Regional General Hospital F. Miulli  Acquaviva delle Fonti metropolitan city of Bari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5970-0157","authenticated-orcid":false,"given":"Hugo R. W.","family":"Touw","sequence":"additional","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Radboud University Medical Hospital  Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviane","family":"Schouten","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Noordwest Ziekenhuisgroep  Alkmaar the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pieter R.","family":"Tuinman","sequence":"additional","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Amsterdam University Medical Centers  Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Amsterdam Institute for Immunity and Infectious Diseases Amsterdam UMC, Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"van Westerloo","sequence":"additional","affiliation":[{"name":"Amsterdam Leiden Intensive Care Focused Echography (ALIFE)  Amsterdam the Netherlands"},{"name":"Department of Intensive Care Medicine Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13089-017-0059-y"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.05.008"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.22374\/cjgim.v13i2.231"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2020.12.002"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2021.01.024"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005760"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182266408"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v11.i2.70"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200401000-00006"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-2800"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-020-00679-3"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/M20-7844"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"100","article-title":"Lung Ultrasound: Routine Practice for the Next Generation of Internists","volume":"73","author":"Touw H.","year":"2015","journal-title":"Netherlands Journal of Medicine"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2513-4"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3952-5"}],"container-title":["Journal of Clinical Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70104","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcu.70104","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcu.70104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:48:54Z","timestamp":1772966934000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcu.70104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/jcu.70104"],"URL":"https:\/\/doi.org\/10.1002\/jcu.70104","archive":["Portico"],"relation":{},"ISSN":["0091-2751","1097-0096"],"issn-type":[{"value":"0091-2751","type":"print"},{"value":"1097-0096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]},"assertion":[{"value":"2025-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}