Aplicação da ultrassonografia portátil no âmbito da clínica médica

Abstract

The research aimed to evaluate whether portable ultrasonography, during clinical consultation in a basic public health unit of the Brazilian Unified Health System, was able to provide reliable additional information for therapeutic decision-making and to reduce the waiting time for a specialized evaluation, by means of the comparison between the findings obtained in portable ultrasonography and conventional ultrasonography. Ultrasonography is the second method of image evaluation more used in medical practice after the X-ray. It does not emit ionizing radiation and its effect on biological tissues is safe, provided that at minimum acoustic intensity level to obtain the desired results. This study was based on the observation of the length of time the patient waits for the ultrasound exams to which Brazilian public health patients are subjected, up to two years in some cases, contrary to recommendation protocols and potentially compromising patient´s health. It evaluated the cost-effectiveness of the technology, its main limitations, the need to create protocols for its use and the subsidies provided for the decision-making by the clinician. The technology was applied in examinations in the areas of internal medicine, musculoskeletal system and cardiology. It was used a portable ultrasound device approved by Anvisa, model Vscan™ Dualprobe. According to protocols of the American Institute of Ultrasound in Medicine (AIUM), the subjects were examined with a portable device, during the moment of the consultation with the researcher, after anamnesis and physical examination. Subsequently, they were submitted to an examination using a conventional device, with a doctor having ultrasound titration. The images and findings were compared between the exams and a global Kappa reliability index was calculated in the three studied areas of 91.12%, although the index for the cardiac area was 76.92%, which demonstrates the limitation of the use of portable ultrasound for the area. The research demonstrated that the use of portable ultrasonography can be an important ally of the clinician, allowing an improvement in the quality of health provided to patients of the Brazilian Unified Health System.