Written by Chris Thom
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In this single-center study, a radiology or cardiology inpatient imaging request followed in only 20% of cases where POCUS was utilized.
POCUS is often the last stop on the imaging train
This was a single-center retrospective study of an inpatient internal medicine department throughout 2023. 572 individual POCUS reports were evaluated to determine if a subsequent radiology or cardiology imaging test had been ordered as a result of the POCUS exam. In 154 (26.9%) cases, there was a subsequent departmental imaging request made. However, 34 of these were for outpatient imaging, leaving 120 instances where a POCUS exam led to a subsequent inpatient imaging request.
The most common POCUS scan type was thoracic, with only 9.6% of scans leading to subsequent imaging. Additional POCUS exam categories included echocardiography, abdomen, renal tract, MSK, and DVT. When excluding the thoracic scans, 35.4% of POCUS scans led to subsequent inpatient imaging.
How does this change my practice?
This study answers an important question. In truth, it likely depends on the experience of the POCUS operator and complexity of the clinical questions they are trying to answer with the tool. In the current study, the authors make the argument that POCUS likely reduces consultative imaging, given that the majority of exams are not followed by radiology or cardiology imaging. However, there was no comparison of downstream imaging before POCUS implementation. It is certainly true that when used with training and expertise, POCUS can start answering clinical questions definitively (e.g. – are there gallstones present? Is there hydronephrosis? Is there an intrauterine pregnancy?, etc). In those cohorts of patients, this would likely drive down consultative imaging rates over time, leading to health care cost savings and efficiency benefits.
Source
Point-of-care ultrasound reduces the impact on departmental radiology and echocardiography services: Results of 1-year service evaluation. Clin Med (Lond). 2025 May;25(3):100306. doi: 10.1016/j.clinme.2025.100306. Epub 2025 Apr 2. PMID: 40185238
