Training Medical Residents in the Use of the Venous Excess UltraSound (VExUS) Score for Bedside Volume Assessment: a Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 23
- 试验地点
- 1
- 主要终点
- Ultrasound Image Quality Score
研究概览
简要总结
This randomized controlled trial evaluates the effectiveness of two training approaches (in-person versus remote) for teaching medical residents to apply the Venous Excess Ultrasound (VExUS) score for bedside volume assessment in patients with acute heart failure. Resident performance will be compared to that of expert physicians certified in abdominal and duplex sonography.
详细描述
Accurate assessment of volume status is essential in managing acute heart failure but remains challenging in clinical practice. The VExUS score is a validated ultrasound-based tool integrating inferior vena cava diameter and Doppler assessment of hepatic, portal, and intrarenal veins.
This single-center randomized controlled trial compares two training modalities (in-person vs. remote) in medical residents with basic ultrasound skills. Participants will be randomized 1:1 to either training method and compared to a control group of expert physicians.
Primary outcomes include ultrasound image quality assessed using a standardized 100-point score. Secondary outcomes include time to acquisition, VExUS scoring accuracy, self-confidence, and acceptability of training methods.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- Single (Outcomes Assessor)
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Medical residents in general internal medicine
- •Basic ultrasound skills (POCUS component 1 or ≥200 scans)
- •Working at study site during study period
排除标准
- •SGUM certification in abdominal ultrasound
- •Advanced duplex ultrasound experience
- •Prior vascular/duplex training
研究组 & 干预措施
In-person Training
1-hour theoretical introduction 3-hour supervised practical ultrasound session Group-based hands-on training with expert coach
干预措施: In-person VExUS Training Program (Behavioral)
Remote Training
E-learning theoretical module 20 independently performed ultrasound exams Asynchronous expert feedback (phone/email)
干预措施: Remote VExUS Training Program (Behavioral)
Control (Expert Physicians)
SGUM-certified physicians performing VExUS examinations
干预措施: No intervention (Other)
结局指标
主要结局
Ultrasound Image Quality Score
时间窗: From training until 6 months after completion of training
The primary outcome will be a quality score, adapted from a quality score used in a previous randomized controlled trial which investigated a simulator-based training program for transoesophageal echocardiography.11 The quality score will include items commonly used for assessment of ultrasound quality: angle and depth, overall clarity, visualization of the anatomical structures, focus, doppler gain, scale and baseline resulting in a maximum achievable quality score of 100 points. If multiple images of the predefined views are captured, each image will be rated, and the best rating will be kept to calculate the final score. If a view is missing, 0 point will be awarded for that view. All ultrasound images will be independently assessed by experts for abdominal sonography and use Doppler sonography in their daily clinical practice and are blinded to the role (resident vs. SGUM-certified physician) and training (in-person vs. remote) program of the participants.
次要结局
- Time for Image Acquisition and Interpretation(From training until 6 months after completion of training)
- Change in self-confidence in performing VExUS assessment(From baseline (before training) to immediately after completion of training)
- Acceptability of the program (quantitative assessment)(Immediately after completion of training and during the outcome assessment period (within 2 months after training))
- VEXUS score(From training until 6 months after completion of training)
- Acceptability of the program (qualitative assessment)(Immediately after completion of training and during the outcome assessment period (within 2 months after training))
研究者
Claudio Schneider
Senior physician
Insel Gruppe AG, University Hospital Bern