ECOSHOT study: Prospective evaluation of a shoulder ultrasound training programme for general practitioners

Abstract

Background and objectiveThe effectiveness of shoulder ultrasound training programmes in primary care is unknown. This study aims to measure the diagnostic agreement between radiologists and general practitioners in shoulder ultrasound examination after a specific training programme. Materials and methodsWe designed a prospective study with patients who required a shoulder ultrasound examination. Ultrasound examination was performed by general practitioners after receiving specific training, consisting of 50 h of theoretical musculoskeletal ultrasound training online and 8 h of hands-on shoulder ultrasound practice. The findings were compared to those of radiologists using Cohen’s Kappa coefficient. Sociodemographic and quantitative variables were also measured. ResultsWe included 153 patients. Finally, 121 radiologists’ reports were used for analyses. The average age was 61.8 years and 62.1% were women. Main occupations were domestic work/cleaning and administrative jobs. Average Visual Analogue Scale score was 5.25. Patients with previous treatment comprised 88.9% (mostly oral painkillers, rest, and physical measures). Complementary testing was performed in 28.8%, radiography was the most frequent. The most frequent motive for referral for ultrasound examination was unspecific shoulder pain. Our study reveals that the global agreement was moderate (Kappa = .4346) overall, but when measured over time improved from weak (Kappa = .3756) to good (Kappa = .6423). There was a tendency to overdiagnose most lesions and underdiagnose partial tears. ConclusionsWe conclude that shoulder ultrasound examination training is feasible in primary care. The interobserver agreement improved with the number of ultrasound examinations performed over time, suggesting that specific programmes may be effective in training general practitioners in musculoskeletal shoulder ultrasound examination.