There remains no doubt that handheld echocardiography has a place among tools used to improve the diagnosis of structural heart disease. The last decade has seen advances in image quality, battery life, portability, file formats and available features, all with increasingly lower costs.1 Handheld ultrasound devices (HUD) have now been used in a wide variety of settings, from emergency departments in the USA to primary healthcare clinics in remote parts of sub-Saharan Africa. Users have been just diverse, ranging from highly skilled echocardiographers to those with only days of ultrasound training. With this diversity of scope and skill, evaluation of the accuracy of these devices is both complex and critical, requiring a robust compilation of available evidence. The current systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of HUD to detect left ventricular systolic dysfunction and to stratify accuracy by the experience of the user. Over 6000 participants from 33 included studies demonstrated that experienced operators could accurately predict reduced left ventricular ejection fraction (LVEF), wall motion abnormalities, LV dilatation and LV hypertrophy, with pooled sensitivities ranging from 85% to 89%, and pooled specificities from 91% to 98%, as compared with conventional transthoracic echocardiography. High performance of experts using handheld ultrasound is less a test of the user (already known to be highly skilled) and more a test of technology, ultimately boosted by the incorporation of high-end features. While each handheld ultrasound has its strengths and weaknesses, and new devices are rapidly entering the market, it is safe to say that in general, these results confirm that HUD have advanced to the point, where they can be used to reliably …

中文翻译：

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提高实现手持超声心动图潜力所需培训的标准化

毫无疑问，手持超声心动图在用于改善结构性心脏病诊断的工具中占有一席之地。在过去十年中，图像质量、电池寿命、便携性、文件格式和可用功能取得了进步，而且成本越来越低。 1 手持式超声设备 (HUD) 现在已被用于各种环境中，从急诊室到美国到撒哈拉以南非洲偏远地区的初级保健诊所。用户只是多种多样，从高技能的超声心动图仪到仅接受过几天超声培训的人。由于范围和技能的多样性，评估这些设备的准确性既复杂又关键，需要对可用证据进行可靠的汇编。当前的系统评价和荟萃分析旨在评估 HUD 检测左心室收缩功能障碍的诊断准确性，并根据用户的经验对准确性进行分层。来自 33 项纳入研究的 6000 多名参与者表明，经验丰富的操作员可以准确预测左心室射血分数 (LVEF) 降低、室壁运动异常、左室扩张和左室肥厚，综合敏感性为 85% 至 89%，综合特异性为 91%与传统的经胸超声心动图相比，高达 98%。使用手持超声的专家的高性能不是对用户的测试（已经知道是高技能的），而是对技术的测试，最终通过结合高端功能来提升。虽然每种手持超声都有其优点和缺点，