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dc.contributor.authorHannan, L Men
dc.contributor.authorSteinfort, D Pen
dc.contributor.authorIrving, L Ben
dc.contributor.authorHew, Men
dc.identifier.citationInternal Medicine Journal; 44(1): 50-6en
dc.description.abstractThere is strong evidence that direct ultrasound localisation for pleural aspiration reduces complications, but this practice is not universal in Australia and New Zealand.To describe the current utilisation and logistical barriers to the use of direct ultrasound localisation for pleural aspiration by respiratory physicians from Australia and New Zealand, and to determine the cost benefits of procuring equipment and training resources in chest ultrasound.We surveyed all adult respiratory physician members of the Thoracic Society of Australia and New Zealand regarding their use of direct ultrasound localisation for pleural aspiration. We performed a cost-benefit analysis for acquiring bedside ultrasound equipment and estimated the capacity of available ultrasound training.One hundred and forty-six of 275 respiratory physicians responded (53% response). One-third (33.6%) of respondents do not undertake direct ultrasound localisation. Lack of training/expertise (44.6%) and lack of access to ultrasound equipment (41%) were the most frequently reported barriers to performing direct ultrasound localisation. An average delay of 2 or more days to obtain an ultrasound performed in radiology was reported in 42.7% of respondents. Decision-tree analysis demonstrated that clinician-performed direct ultrasound localisation for pleural aspiration is cost-beneficial, with recovery of initial capital expenditure within 6 months. Ultrasound training infrastructure is already available to up-skill all respiratory physicians within 2 years and is cost-neutral.Many respiratory physicians have not adopted direct ultrasound localisation for pleural aspiration because they lack equipment and expertise. However, purchase of ultrasound equipment is cost-beneficial, and there is already sufficient capacity to deliver accredited ultrasound training through existing services.en
dc.subject.otherdecision treeen
dc.subject.otherpleural diseaseen
dc.subject.otherpleural effusionen
dc.subject.otherBiopsy, Needle.economics.methodsen
dc.subject.otherCost-Benefit Analysisen
dc.subject.otherData Collectionen
dc.subject.otherDecision Treesen
dc.subject.otherDurable Medical & distributionen
dc.subject.otherEducation, Medical, Continuingen
dc.subject.otherHealth Expendituresen
dc.subject.otherHealth Services Accessibilityen
dc.subject.otherPhysician's Practice Patterns.statistics & numerical dataen
dc.subject.otherPleural Effusion.diagnosis.pathologyen
dc.subject.otherPoint-of-Care Systems.economics.utilizationen
dc.subject.otherPractice Guidelines as Topicen
dc.subject.otherProfessional Practice.classificationen
dc.subject.otherUltrasonography, Interventional.economics.instrumentation.utilizationen
dc.titleDirect ultrasound localisation for pleural aspiration: translating evidence into action.en
dc.typeJournal Articleen
dc.identifier.journaltitleInternal Medicine Journalen
dc.identifier.affiliationDepartment of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australiaen
dc.identifier.affiliationInstitute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australiaen
dc.type.austinJournal Articleen
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
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