Tommy Heyne

We still have a few open spots for the #HarvardMedicalSchool / #MGB Procedure and #POCUS courses in Boston (Nov 1-2), led by the legendary @aliteplo . Discount available for trainees. learn.hms.harvard.edu/programs/mgb-p…

Representing @PennMedicine and @MGHMedicine, teaching with @cameron_baston at the ACP National #POCUS course for @ACPIMPhysicians. And yes, that's a tie with B-lines in multiple windows.

Happy St Valentine's Day to all POCUS aficionados! ❤️ POCUS

Rest in peace, Ma'am.

Another great #POCUS ACP precourse for ⁦@ACPinternists⁩, led by superb MDs ⁦@NsquaredPOCUS⁩ and ⁦@sunnydmtierney⁩. Love seeing learners grow so quickly in their POCUS skills. Even as faculty, I always learn new tricks and tips.

I love the Russian people. That is why I have to tell you the truth. Please watch and share.

Dan was such a kind and knowledgeable physician: this is a tremendous loss for the Med+Peds POCUS family. I will be forever grateful for his insights and advice. He will certainly be missed. Prayers for his family. #IMPOCUS #MedPedsPOCUS

Please get vaccinated

@jeanniegaffigan Happy to help… theology Master’s from Oxford, M.D. from UT, residency and now faculty at Harvard Med. PM me if you still need help. Thanks for writing ur husband’s jokes- my wife (another MD) & I love them!

The best of all worlds- POCUS, IM, and Peds!!

Looking for the perfect gift for your US fellows for graduation or for your US faculty? The Ultrasound Alphabet poster is a unique way to add pizzazz to your office. Comes in two sizes, framed or unframed. And supports a good cause! #POCUS @MedPOCUS surveymonkey.com/r/D92YP72

So, in conclusion, POCUS outperformed CXR to predict a positive PCR. POCUS could _potentially_ replace other chest imaging modalities for "persons under investigation for COVID-19" (as we call them at @MGHMedicine).

Here's how well the MGH 4-zone Protocol might work in practice: Using a 2point cutoff, ...sensitivity would be 0.920 and 0.904 compared to CT and PCR, respectively, at the lower cutoff ..specificity would be 0.926 and 0.948 at the higher cutoff, respectively. CHF pts similar.

Comparing the CT, POCUS with the MGH 4-zone Protocol did better than CXR (p=0.0471) and about as good as CT. AUCs for simplified POCUS, CT, and CXR were 0.86, 0.82, and 0.79, respectively. What's interesting is that the full 14-zone POCUS protocol did not do as well.

The "MGH 4-zone Protocol" only uses four instead of all 14 zones. These are the posterior zones (which, coincidentally, might reduce exposure of the examiner). The score is developed looking at B-lines: are there 1-2, >2, or confluent/coalescing B-lines. Interpretation below

Comparing ROC curves with a (+) CT as the comparison, CXR had an area under the curve of 0.733 (95% CI: 0.60-0.86). A full POCUS scan had an AUC of 0.82 (0.70-0.91). We developed a simplified, MGH 4-zone protocol (see next tweet), the AUC was similar - 0.86 (95% CI: 0.77-0.93).

Can we replace CT with ultrasound when a diagnosis of COVID-19 is uncertain? How good does #POCUS fare compare to CT and CXR to diagnose COVID-19 by PCR? Can the #POCUS 12-zone lung algorithm be simplified? Our need study (pre-print: medrxiv.org/content/10.110…) is out! Thread

Additional study authors: @Smith__etc @Ahad_AlSaud @chillmilk @lucas_marinacci @bplittle @DexterMendozaMD @EJFloresMD

We welcome any centers wishing to perform validation studies!

📣📣Four-zone, posterior lung #POCUS w handheld probe can help diagnose #COVID (both +PCR and high-suspicion CT). AUC 0.86; sensitivity & specificity >90%. Our #MGH 4-Zone Score Study preprint: tinyurl.com/246ubb7s @ben_geisler @aliteplo @HamidShokoohiMD