CHEST Guidelines-Guidelines-for-Ultrasound-Training-in-Critical-Car

Guidelines-for-Ultrasound-Training-in-Critical-Car

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The use of ultrasound imaging in critical care is becoming widespread across various medical fields, necessitating proper training to minimize unnecessary examinations and misdiagnoses. Numerous guidelines and consensus statements on ultrasound training have been published, aiming to define competence and suggest training methodologies. However, the recommendations often rely heavily on expert opinions rather than high-quality evidence, resulting in variability among guidelines.<br /><br />In an issue of CHEST, a study by Rajamani et al. evaluated the methodological quality of guidelines concerning basic point-of-care ECG training in critical care (BCCE). This systematic review included guidelines published in peer-reviewed journals or on societal websites, with a focus on their methodological rigor assessed using the AGREE-II instrument, a tool developed for appraising clinical practice guidelines.<br /><br />The review discovered that, among the 24 guidelines meeting inclusion criteria, only a fraction performed satisfactorily in terms of clarity and comprehensive training recommendations. Specifically, 11 guidelines recommended introductory courses, but few provided detailed course components, and only eight emphasized the importance of longitudinal training programs. Moreover, just five guidelines attained a 75% score on the AGREE-II scale, a benchmark intended to identify guidelines requiring no modification.<br /><br />While this review highlights the lack of high-quality guidelines, it remains uncertain whether employing systematic methods during guideline creation will tangibly improve training and competence outcomes. The findings call for future well-structured guidelines that clearly articulate the methods and rationale behind recommendations for training programs. Furthermore, the study emphasizes the need for strategies that facilitate the implementation of these recommendations at national and local levels. Despite the abundance of guidelines, practical application in critical care settings continues to face challenges such as scarcity of qualified trainers and consensus on competencies.

Keywords

ultrasound imaging

critical care

training guidelines

misdiagnoses

AGREE-II instrument

systematic review

point-of-care ECG

methodological quality

longitudinal training

competence outcomes