💙 POCUS, global health, the arts | Assoc Dir of Faculty U/S @MGHMedicine | POCUS Lead @MGHHMU | MD @HarvardMed & @ArtsatHMS | Catholic Dad | Opinions mine
Joined November 2019
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We still have a few open spots for the #HarvardMedicalSchool / #MGB Procedure and #POCUS courses in Boston (Nov 1-2), led by the legendary @aliteplo .
Discount available for trainees.
learn.hms.harvard.edu/progra…
Representing @PennMedicine and @MGHMedicine, teaching with @cameron_baston at the ACP National #POCUS course for @ACPIMPhysicians. And yes, that's a tie with B-lines in multiple windows.
Another great #POCUS ACP precourse for @ACPinternists, led by superb MDs @NsquaredPOCUS and @sunnydmtierney. Love seeing learners grow so quickly in their POCUS skills. Even as faculty, I always learn new tricks and tips.
Tommy Heyne retweeted
I love the Russian people. That is why I have to tell you the truth. Please watch and share.
Dan was such a kind and knowledgeable physician: this is a tremendous loss for the Med+Peds POCUS family. I will be forever grateful for his insights and advice. He will certainly be missed. Prayers for his family. #IMPOCUS #MedPedsPOCUS
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The best of all worlds- POCUS, IM, and Peds!!
Right @Sono4Pyro @TanpingWong @IMSonoSC @SonoInternist @WCM_HMPOCUS ?! We're VERY excited to have 3 fab fellows joining us next mo, 2 of whom are our first med-peds fellows ever! HT to med-peds #POCUS gurus we'll be hitting up for advice: @ria_dancel, @MedPOCUS & Dan Schnobrich.
Tommy Heyne retweeted
Looking for the perfect gift for your US fellows for graduation or for your US faculty? The Ultrasound Alphabet poster is a unique way to add pizzazz to your office. Comes in two sizes, framed or unframed. And supports a good cause! #POCUS @MedPOCUS surveymonkey.com/r/D92YP72
Tommy Heyne retweeted
So, in conclusion, POCUS outperformed CXR to predict a positive PCR.
POCUS could _potentially_ replace other chest imaging modalities for "persons under investigation for COVID-19" (as we call them at @MGHMedicine).
Tommy Heyne retweeted
Here's how well the MGH 4-zone Protocol might work in practice:
Using a 2point cutoff,
...sensitivity would be 0.920 and 0.904
compared to CT and PCR, respectively, at the lower cutoff
..specificity would be 0.926 and 0.948 at the higher cutoff, respectively.
CHF pts similar.
Tommy Heyne retweeted
Comparing the CT, POCUS with the MGH 4-zone Protocol did better than CXR (p=0.0471) and about as good as CT.
AUCs for simplified POCUS, CT, and CXR were 0.86, 0.82, and 0.79, respectively.
What's interesting is that the full 14-zone POCUS protocol did not do as well.
Tommy Heyne retweeted
The "MGH 4-zone Protocol" only uses four instead of all 14 zones.
These are the posterior zones (which, coincidentally, might reduce exposure of the examiner).
The score is developed looking at B-lines: are there 1-2, >2, or confluent/coalescing B-lines.
Interpretation below
Tommy Heyne retweeted
Comparing ROC curves with a (+) CT as the comparison, CXR had an area under the curve of 0.733 (95% CI: 0.60-0.86).
A full POCUS scan had an AUC of 0.82 (0.70-0.91).
We developed a simplified, MGH 4-zone protocol (see next tweet), the AUC was similar - 0.86 (95% CI: 0.77-0.93).
Tommy Heyne retweeted
Can we replace CT with ultrasound when a diagnosis of COVID-19 is uncertain?
How good does #POCUS fare compare to CT and CXR to diagnose COVID-19 by PCR?
Can the #POCUS 12-zone lung algorithm be simplified?
Our need study (pre-print: medrxiv.org/content/10.1101/…) is out!
Thread
📣📣Four-zone, posterior lung #POCUS w handheld probe can help diagnose #COVID (both +PCR and high-suspicion CT). AUC 0.86; sensitivity & specificity >90%. Our #MGH 4-Zone Score Study preprint: tinyurl.com/246ubb7s
@ben_geisler @aliteplo @HamidShokoohiMD
Additional study authors: @Smith__etc @Ahad_AlSaud @chillmilk @lucas_marinacci @bplittle @DexterMendozaMD @EJFloresMD
Thank you, @CardinalSean !
I urge all to be vaccinated when possible, an important action of care & concern for loved ones, communities & our nation. We are blessed with highly skilled nurses & medical professionals like Eileen Kolodny, MSN RN-BC @StElizabethsMC here giving me the COVID-19 vaccine.
