Abstract
Why …should we rely on indirect information and secondary acoustic events when we actually can see what is wrong with the heart and its structures? J.R.T.C. Roelandt1
A few years ago I had the opportunity to test the latest generation of ultra-portable, hand-held ultrasound devices (HHUS). After a single day with the pocket-sized device, high-end echo scanners, and many patients with a variety of cardiac pathologies, I was soon convinced of the diagnostic quality. From that moment on I rarely forgot to take an ultra-portable scanner with me when I went to cardiac consultations on the wards, the emergency department, or the intensive care unit. The ‘ultrasound stethoscope’ immediately became an indispensable clinical reality as it had been prophesied decades ago by the late Professor Joes Roelandt.1 My classical stethoscope had lost its position as my favourite tool in the physical exam, although it never was completely put aside.
However, my sceptical colleagues asked whether the image quality really was good enough—I had seen excellent images in many patients. The naysayers stressed that there was no spectral Doppler to quantify flow velocities—I had seen several valvular pathologies and had correctly anticipated the high-grade stenosis or regurgitation with only 2D and color-Doppler information. Maybe only a good guess? The protectionists reminded me that special expertise is required and that a broad spread use might lead to erroneous conclusions—well, I was confident on my personal expertise, but what about the other colleagues who might get their hands on the device? Maybe the sceptics, naysayers, and protectionists had a point?
I realized that better scientific evidence would be required to support Professor Roelandt’s vision of the ultrasound stethoscope.1 Personal beliefs and subjective experiences do not mean much in today’s era of evidence-based medicine. …