Tele-Guidance for Point-of-Care Ultrasound: A Prospective Diagnostic Study

This study evaluated the effectiveness of physician tele-guidance in improving ultrasound image acquisition by individuals with no prior medical or ultrasound training. Point-of-care ultrasound (POCUS) is vital for enhancing diagnostic accuracy and enabling timely medical interventions, especially in remote areas that lack trained ultrasound professionals and imaging resources. However, handheld ultrasound probes like the Butterfly iQ+ offer potential solutions, including tele-guidance capabilities, that could assist untrained users. In this prospective study, 30 participants were divided into two groups: an experimental group receiving real-time guidance from a physician using the probe’s tele-guidance feature, and a control group with no assistance. All participants watched a standardized ultrasound tutorial video before attempting to capture images of the heart, right kidney, and gallbladder. Image acquisition time and quality were assessed, with the images evaluated by three blinded radiologists using the RACE tool. Results demonstrated that the control group had significantly longer imaging times across all organs (p < 0.0001) and lower image quality scores compared to the tele-guided group. Additionally, diagnostic quality was markedly higher in the tele-guided group, with increased interpretability for identifying conditions such as pericardial fluid, intraperitoneal fluid, and acute cholecystitis. The findings indicate that tele-guidance significantly enhances both the speed and clinical utility of ultrasound images captured by untrained users, suggesting that tele-guided POCUS could be a valuable tool in underserved areas to improve access to essential diagnostic imaging.