{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:17Z","timestamp":1790586017436,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":["Echocardiography"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital heart disease (CHD) remains a leading cause of neonatal morbidity and mortality worldwide, with a significant proportion of cases remaining undetected before birth. While pediatric cardiologist\u2010performed echocardiography represents the diagnostic gold standard, access to specialist services is limited across many neonatal care settings globally. Neonatologist\u2010performed point\u2010of\u2010care echocardiography has emerged as a bedside diagnostic tool; however, the evidence supporting its diagnostic performance and clinical impact requires systematic evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review the diagnostic performance and clinical impact of point\u2010of\u2010care echocardiography performed by neonatologists or trained non\u2010cardiologist clinicians for the early detection of cardiac lesions in neonates across diverse clinical settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed and Google Scholar was conducted in April 2026, supplemented by reference list screening of all included studies (198 additional records screened), forward citation searches (32 additional records), and a supplementary Embase search conducted in August 2026 in response to peer review. Studies evaluating neonatologist\u2010performed echocardiography in neonates aged 0\u201328 days, reporting diagnostic performance metrics or clinical impact outcomes with a cardiologist comparator or confirmed diagnosis as reference standard, were included. Methodological quality was assessed using the QUADAS\u20102 tool. Due to substantial clinical and methodological heterogeneity, findings were synthesized narratively in accordance with PRISMA 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen primary studies (2008\u20132026, including two ahead\u2010of\u2010print articles) from eleven countries encompassing over 31\u00a0800 neonates were included and synthesized across three domains: diagnostic performance and agreement, CHD detection capability, and clinical impact. Concordance between neonatologist and cardiologist echocardiography ranged from 91.15% to 97.9% (kappa 0.68\u20130.862). One population\u2010based screening study reported sensitivity of 92% and specificity of 99.6%. No cases of missed major or critical CHD were reported in the included studies, although evidence remains limited and predominantly retrospective. Neonatologist\u2010performed echocardiography was associated with management changes in 48%\u201366% of consultations involving structural or mixed cardiac assessment, and in up to 79% of consultations addressing hemodynamic indications alone (patent ductus arteriosus, pulmonary hypertension, systemic hypotension). Formal diagnostic accuracy data were limited to one study, and heterogeneity precluded meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence supports moderate\u2010to\u2010high diagnostic agreement and potential clinical utility of neonatologist\u2010performed point\u2010of\u2010care echocardiography for identifying major and critical neonatal cardiac lesions. Evidence suggests this modality may be most appropriately utilized as an initial bedside triage and rule\u2010in tool in settings where immediate pediatric cardiology access is limited. However, robust diagnostic accuracy data remain limited, and high\u2010quality prospective multicenter validation studies are urgently required before definitive conclusions can be drawn.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70617","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:01:38Z","timestamp":1790038898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Performance and Clinical Impact of Point\u2010of\u2010Care Echocardiography for Early Detection of Neonatal Cardiac Lesions: A Systematic Review"],"prefix":"10.1111","volume":"43","author":[{"given":"Komal","family":"Mushtaq","sequence":"first","affiliation":[{"name":"Worcester Royal Hospital  England UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Talha","family":"Javeed","sequence":"additional","affiliation":[{"name":"NUST, SEECS  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-021-02997-2"},{"issue":"10","key":"e_1_2_10_3_1","article-title":"The Burden of Neonatal Referrals on a Pediatric Cardiology Service: A Local Center Experience","volume":"15","author":"Al Maddallah W. 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