For a study, researchers sought to evaluate the diagnostic accuracy of the parasternal long axis (PSLA) view in isolation from a four-view FOCUS assessment for diagnosing pericardial effusion, left ventricular (LV) dysfunction, and right ventricular (RV) dilatation.
It was research that looked back at FOCUS photographs. The exams were blinded and randomized before being reviewed by point-of-care ultrasonography professionals. The primary goal was achieved by comparing ultrasonography results on a single PSLA view to findings on a full four-view FOCUS examination, which served as the criteria standard. In addition, specificity and sensitivity were calculated.
Of the 100 FOCUS exams, 36% were normal, 16% had a pericardial effusion, 41% had an LV ejection fraction <50%, and 7% had RV dilatation. Sensitivity and specificity for detecting pericardial effusion, LV dysfunction, and RV dilatation were 81% [CI] 0.54-0.95) and 98% (95% CI 0.91-0.99), 100% (95% CI 0.88–1) and 91% (95% CI 0.80–0.97), and 71% (95% CI 0.30–0.94) and 99% (95% CI 0.93–1), respectively. Every moderate to big effusion was accurately detected. Only four clinically meaningful differences between PSLA alone and the four-view interpretations were found.
When used alone, the PSLA view was extremely sensitive and specific for detecting LV ejection percent and moderate to large pericardial effusions. In addition, it exhibited an excellent specificity for detecting RV dilatation but a low sensitivity.