{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T21:32:31Z","timestamp":1783978351361,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Left atrial enlargement (LAE) is predictive of cardiovascular morbidity and mortality. Prior studies of point\u2010of\u2010care ultrasound (POCUS) interpretation methods for identifying LAE utilized older echocardiographic reference ranges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Compare the test characteristics of hospitalist\u2010performed POCUS techniques for identifying LAE as compared to contemporary echocardiographic reference ranges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fully paired, comparative diagnostic accuracy study of two index tests applied to archived echocardiogram images: visual assessment of the left atrium to aorta diameter (LAE sign) and left atrial (LA) anteroposterior diameter &gt;4\u2009cm in the parasternal long axis view. The reference test was moderate to severe LAE by echocardiography\u2010derived left atrial volumetric index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After exclusion criteria, 239 of 321 (74.5%) exams were included. The LAE sign had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 67.5%, 71.4%, 32.1%, and 91.6%. LA diameter of &gt;4\u2009cm had a sensitivity, specificity, PPV, and NPV of 87.5%, 75.9%, 42.2%, and 96.8%. The difference in sensitivity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.005) and specificity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.049) between the index tests was statistically significant. The diameter measurement had better positive and negative likelihood ratios (LR\u2009+\u20093.63, LR\u22120.16) than the LAE sign (LR\u2009+\u20092.36, LR\u2212 0.46).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both POCUS techniques for diagnosing LAE performed reasonably well compared to current echocardiographic reference ranges, with LA diameter &gt;4\u2009cm having better sensitivity and specificity than visual estimation of the LAE sign. These tests can help identify patients at risk for cardiovascular disease who may benefit from echocardiogram referral.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70245","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T14:40:23Z","timestamp":1765636823000},"page":"741-748","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative diagnostic accuracy study of point of care ultrasound techniques for detection of left atrial enlargement by hospital medicine physicians from archived echocardiogram images"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6417-0824","authenticated-orcid":false,"given":"Christopher J.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Hospital Medicine University of Nebraska Medical Center Omaha Nebraska 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