Diagnostic of Lower Respiratory Tract Infection by Lung Ultrasonography in General Practice

Study Overview
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Brief Summary
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Lower Respiratory Tract Infection (LRTI) is a frequent motive of consultation in General Practice. Cost, irradiation and availability of traditional imagery make it difficult to perform in every patient with suspected LRTI. The objective is to evaluate the performance of LUS realized by family physicians into the usual LRTI diagnostic pathway. This study is a prospective, interventional, multi-centric and open study conducted in 3 different centers by 15 General Practitioners (GP) in France. Patient complaining of dyspnea or cough were recruited from December 2019 to March 2020. GP received a training course by LUS expert before the study. The primary outcome measure was diagnosis modification after LUS. Secondary measures were therapeutic modification after LUS, decision of imagery prescription after LUS, decision of hospitalization or not after LUS, medical evolution and result of imagery initially prescribed by GP.

Detailed Description
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After an initial medical report, GP's concluded to an initial diagnosis and make initial prescription and finally decided or not to perform a standardized eight-points LUS. GP were free to perform or not LUS. If GP decided to perform LUS, GP were allowed to change their diagnosis and prescriptions (LUS group). However, therapeutic changes after LUS could not downgrade patient care.

Official Title
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Diagnosis of Lower Respiratory Tract Infection by Lung Ultrasonography in General Practice : a Prospective, Interventional and Multicentric Study

Conditions
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Lower Resp Tract Infection, Ultrasound Therapy; Complications

Intervention / Treatment
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* Diagnostic Test: Lung ultrasonography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age > 3 months Dyspnea or cough complaint Exclusion Criteria: Age < 3 months Rejection to participate to the study

Ages Eligible for Study
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Minimum Age: 3 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Among the 151 patients included, 111 LUS were performed (LUS group)
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LUS group<br> | Diagnostic Test: Lung ultrasonography<br>* Investigators performed lung ultrasonography on patients<br>|
| No Intervention: No LUS group<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnosis modification | Diagnosis modification after lung ultrasonography | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Therapeutic modification | Therapeutic modification after lung ultrasonography | 3 months | 
| Imagery prescription | Decision of imagery prescription after lung ultrasonography | 3 months | 
| Decision of hospitalization | Decision of an hospitalization or not after lung ultrasonography | 3 months | 
| Medical evolution | Medical evolution at 7 days (improvement, persistence, worsening and hospitalization) | 3 months | 
| Imagery result | Result of imagery initially prescribed by general practitioners (Chest CT-Scan or X-Ray) | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lung ultrasonography, Lower Respiratory Tract Infection, General Practice