{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:50:17Z","timestamp":1781776217241,"version":"3.54.5"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009750","name":"Medical Center, University of Rochester","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009750","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Point-of-care ultrasound (POC-US) is a diagnostic test conducted at the site of patient care with direct interpretation by the clinician, providing immediate results. POC-US for gynecologic application is not well characterized by current literature yet has the potential to increase access in limited resource settings. We compared the diagnostics of three POC-US devices for gynecologic (GYN) pathology and then performed evaluation of sensitivity and specificity of a single best POC-US device for intended use in a low resource setting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is prospective, pilot descriptive study of 60 subjects. In part 1, comparison of three POC-US devices was performed. Twenty subjects underwent POC-US with three test units [GE Vscan (Vscan), Sonosite Iviz (Iviz), Philips Lumify (Lumify)] followed by diagnostic ultrasound (Dx-US) for reference imaging. Image quality and correlation for devices was scored by blinded reviewers and quantitative measurements of GYN pathology were compared. In part 2, forty subjects underwent POC-US validation with the highest scoring device (Lumify) and Dx-US for reference imaging. Concordance of POC-US operator-interpreted diagnosis with reference imaging interpretation were assessed by Cohen\u2019s unweighted kappa coefficient. Accuracy and agreement of POC-US were assessed by linear regression and Bland\u2013Altman plot analysis. Sensitivity and specificity of POC-US for gynecologic pathologies were calculated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In aggregate qualitative measurements, Lumify and Iviz units performed superiorly to Vscan. There was no statistically significant difference in quantitative measurements between devices, but a trend towards lower mean error was seen for Lumify and Iviz as compared to Vscan. Lumify device had highest overall scoring and was selected for further testing. In validation comparison of Lumify to Dx-US, no statistically significant differences were found for measurements of endometrium, uterus, ovaries, adnexal pathology, or leiomyomata, (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.02) with excellent agreement in operator-interpreted diagnosis (Kappa\u2009&gt;\u20090.7). Sensitivity and specificity of detecting pathology was 80\u2013100% with PPV and NPV 76\u2013100%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Among three POC-US devices, Lumify and Iviz devices show highest potential for successful application to clinical gynecologic ultrasound. Clinician-performed POC-US has high diagnostic accuracy, sensitivity, and specificity for basic GYN anatomy and pathology. POC-US is an acceptable and feasible diagnostic tool with potential for future application in a low resource setting to increase access to ultrasound.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-020-00518-8","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T08:03:05Z","timestamp":1603785785000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Evaluating sensitivity and specificity of handheld point-of-care ultrasound testing for gynecologic pathology: a pilot study for use in low resource settings"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7746-2866","authenticated-orcid":false,"given":"Marika","family":"Toscano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kam","family":"Szlachetka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Whaley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loralei L.","family":"Thornburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,27]]},"reference":[{"key":"518_CR1","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.ultrasmedbio.2016.06.021","volume":"43","author":"CG Dietrich","year":"2017","unstructured":"Dietrich CG, Chiorean A, Cui L, Gilia XW, Dong OH, Abramowicz Y, Vinayak JS, Westerway S, Nolsoe SC, Chou CP, Blaivas YHM. Point of care ultrasound: a WFUMB position paper. Ultrasound Med Biol. 2017;43:49\u201358.","journal-title":"Ultrasound Med Biol."},{"issue":"3","key":"518_CR2","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1517\/17530059.2012.669368","volume":"6","author":"CJ-O Frederiksen","year":"2012","unstructured":"Frederiksen CJ-O, Sloth PE. Advances in imaging: ultrasound in every physician\u2019s pocket. Expert Opin Med Diagnost. 2012;6(3):167\u201370.","journal-title":"Expert Opin Med Diagnost"},{"key":"518_CR3","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1002\/uog.11184","volume":"2012","author":"APJ Sayasneh","year":"2012","unstructured":"Sayasneh APJ, Smith A, Saso S, Naji O, Abdallah Y, Stalder C, Daemen A, Timmerman D, Bourne T. Do pocket-sized ultrasound machines have the potential to be used as a tool to triage patients in obstetrics and gynecology? Ultrasound Obstet Gynecol. 2012;2012:145\u201350.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"518_CR4","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1002\/uog.13285","volume":"2014","author":"SBS Galjaard","year":"2014","unstructured":"Galjaard SBS, Ameye L, Bourne T, Timmerman D, Devlieger R. Use of pocket-sized ultrasound machine (PUM) for routine examinations in the third trimester of pregnancy. Ultrasound Obstet Gyncol. 2014;2014:64\u20138.","journal-title":"Ultrasound Obstet Gyncol"},{"key":"518_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1865-1380-4-72","volume":"4","author":"SM Sippel","year":"2011","unstructured":"Sippel SM, Levine K, Shah AS. Review article: use of ultrasound in the developing world. Int J Emerg Med. 2011;4:1\u201311.","journal-title":"Int J Emerg Med"},{"issue":"6","key":"518_CR6","doi-asserted-by":"publisher","first-page":"325","DOI":"10.11622\/smedj.2014078","volume":"55","author":"KHLW Tse","year":"2014","unstructured":"Tse KHLW, Lam MC. Pocket-sized versus standard ultrasound machines in abdominal imaging. Singapore Med J. 2014;55(6):325\u201333.","journal-title":"Singapore Med J"},{"issue":"3","key":"518_CR7","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1111\/tmi.12657","volume":"21","author":"DM Becker","year":"2015","unstructured":"Becker DM, Tafoya CA, Becker SL, Kruger GH, Tafoya MJ, Becker TK. The use of portable ultrasound devices in low- and middleincome countries: a systematic review of the literature. Tropical Med Int Health. 2015;21(3):294\u2013311.","journal-title":"Tropical Med Int Health"},{"issue":"5","key":"518_CR8","first-page":"1272","volume":"76","author":"QMRJ Ali","year":"1999","unstructured":"Ali QMRJ, Abdel-Rahim IM, Franke D, Kardorff R, Schweisfurth H, Doehring E. Cost saving with ultrasonography in a developing country district hospital. East Afr Med J. 1999;76(5):1272\u20134.","journal-title":"East Afr Med J"},{"key":"518_CR9","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/0140-6736(91)90981-T","volume":"337","author":"T Mets","year":"1991","unstructured":"Mets T. Clinical ultrasound in developing countries. Lancet. 1991;337:358.","journal-title":"Lancet"},{"issue":"3","key":"518_CR10","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1007\/s002610000035","volume":"25","author":"ETMP Tshibwabwa","year":"2000","unstructured":"Tshibwabwa ETMP, Bogle-Taylor J. Four year study of abdominal ultrasound in 900 Central African Adults with AIDS referred for diagnostic imaging. Abdom Imaging. 2000;25(3):290\u20136.","journal-title":"Abdom Imaging"},{"key":"518_CR11","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.amjcard.2004.04.077","volume":"90","author":"SLLS Kobal","year":"2004","unstructured":"Kobal SLLS, Willner R, Aguila-Vargas FE, Luo H, Watanabe C, Neuman Y, Miyamoto T, Siegel RJ. Hand carried ultrasound enhances health care delivery in developing countries. Am J Cardiol. 2004;90:539\u201341.","journal-title":"Am J Cardiol"},{"key":"518_CR12","doi-asserted-by":"crossref","unstructured":"Shah SE, H. Bukhman, G. Impact of the introduction of ultrasound services in a limited resource setting: rural Rwanda BMC int health hum rights. 2009;9:1\u201311.","DOI":"10.1186\/1472-698X-9-4"},{"key":"518_CR13","doi-asserted-by":"publisher","first-page":"119","DOI":"10.4269\/ajtmh.1999.60.119","volume":"60","author":"JPBJ Steinmetz","year":"1999","unstructured":"Steinmetz JPBJ. Ultrasonography as an aid to diagnosis and treatment in a rural African Hospital: a prospective study of 1,119 cases. Am J Trop Med Hyg. 1999;60:119\u201323.","journal-title":"Am J Trop Med Hyg"},{"key":"518_CR14","doi-asserted-by":"publisher","first-page":"10","DOI":"10.4103\/0974-2700.41785","volume":"1","author":"SMCL Kotylar","year":"2008","unstructured":"Kotylar SMCL. Assessing use of ultrasound in Liberia. J Emerg Trauma Shock. 2008;1:10\u20134.","journal-title":"J Emerg Trauma Shock"},{"key":"518_CR15","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.7863\/jum.2008.27.12.1735","volume":"27","author":"JKAR Spencer","year":"2008","unstructured":"Spencer JKAR. Utility of portable ultrasound in a community in Ghana. J Ultrasound Med. 2008;27:1735\u201342.","journal-title":"J Ultrasound Med"},{"key":"518_CR16","doi-asserted-by":"crossref","unstructured":"AIUM practice guideline for the performance of pelvic ultrasound examinations. J Ultrasound Med 2010;29(1):166\u201372.","DOI":"10.7863\/jum.2010.29.1.166"},{"issue":"1","key":"518_CR17","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1177\/0049124112452527","volume":"43","author":"P Sturgis","year":"2014","unstructured":"Sturgis P, Roberts C, Smith P. Middle alternatives revisited: how the neither\/nor response acts as a way of saying \u201cI don\u2019t know\u201d? Sociol Methods Res. 2014;43(1):15\u201338.","journal-title":"Sociol Methods Res"},{"issue":"3","key":"518_CR18","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1002\/uog.14806","volume":"46","author":"T Van den Bosch","year":"2015","unstructured":"Van den Bosch T, Dueholm M, Leone FPG, Valentin L, Rasmussen CK, Votino A, et al. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group. Ultrasound Obstet Gynecol. 2015;46(3):284\u201398.","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"518_CR19","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1148\/radiol.10100213","volume":"256","author":"D Levine","year":"2010","unstructured":"Levine D, Brown DL, Andreotti RF, Benacerraf B, Benson CB, Brewster WR, et al. Management of asymptomatic ovarian and other adnexal cysts imaged at US: society of radiologists in ultrasound consensus conference statement. Radiology. 2010;256(3):943\u201354.","journal-title":"Radiology"},{"issue":"5","key":"518_CR20","doi-asserted-by":"publisher","first-page":"e124","DOI":"10.1097\/AOG.0000000000002631","volume":"131","author":"ACOG Committee Opinion No","year":"2018","unstructured":"ACOG Committee Opinion No. 734: The role of transvaginal ultrasonography in evaluating the endometrium of women with postmenopausal bleeding. Obstet Gynecol. 2018;131(5):e124\u20139.","journal-title":"Obstet Gynecol"},{"key":"518_CR21","doi-asserted-by":"publisher","first-page":"h5527","DOI":"10.1136\/bmj.h5527","volume":"351","author":"PM Bossuyt","year":"2015","unstructured":"Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ: Br Med J. 2015;351:h5527.","journal-title":"BMJ: Br Med J"},{"key":"518_CR22","doi-asserted-by":"publisher","first-page":"639","DOI":"10.2471\/BLT.16.187468","volume":"95","author":"CS Kosack","year":"2017","unstructured":"Kosack CS, Page A-L, Klatser PR. A guide to aid the selection of diagnostic tests. Bull World Health Organ. 2017;95:639\u201345.","journal-title":"Bull World Health Organ"},{"issue":"3","key":"518_CR23","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/S1473-3099(13)70250-0","volume":"14","author":"PK Drain","year":"2014","unstructured":"Drain PK, Hyle EP, Noubary F, Freedberg KA, Wilson D, Bishai W, et al. Evaluating diagnostic point-of-care tests in resource-limited settings. Lancet Infect Dis. 2014;14(3):239\u201349.","journal-title":"Lancet Infect Dis"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-020-00518-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-020-00518-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-020-00518-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T23:10:48Z","timestamp":1635289848000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedimaging.biomedcentral.com\/articles\/10.1186\/s12880-020-00518-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,27]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["518"],"URL":"https:\/\/doi.org\/10.1186\/s12880-020-00518-8","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,27]]},"assertion":[{"value":"15 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval was obtained from the University of Rochester Medical Center institutional review board (Rochester, NY). Written informed consent was obtained from all subjects prior to enrollment.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"121"}}