Sonography and Ultrasound in Global Health Scientific Session
Train-the-trainer POCUS program for pediatric pneumonia in a low-resource setting
Monday, April 8, 2024
7:39am – 7:46am
Location: 412
Authors: Michelle Lee, Hospital for Sick Children AMERTA Ladhani, Aga Khan University hmHospital Mark Tessaro, Hospital for Sick Children HUBA ATIQ, Aga Khan University Hospital Fatima Mir, the aga khan University Shaun Morris, Hospital for Sick Children ,
POCUS is a promising diagnostic modality for pediatric pneumonia with the potential of transforming care especially in resource-limited settings. Task shifting of POCUS to general practitioners have been reported with promising results, but many studies relied on remote expert review of images uploaded by the novice users – what would happen to the interrater reliability if local experts obtained their own scans on the same patients? Our project set out to answer this question by delivering and evaluating a train-the-trainer POCUS program in Pakistan. This multi-modal program was first delivered to local champions (with prior POCUS experience), who were coached to subsequently train community health workers (novice POCUS users) on using POCUS to diagnose pediatric pneumonia. Indeed, what we found was that the interrater reliability differed. The kappa agreement was strong when relying on remote expert review of uploaded scans, but when the CHW or local champion each performed and interpreted their own scans, the Kappa agreement dropped to 0.66. This finding suggests that interrater agreement may be falsely inflated if we rely strictly on remote expert review – implicating the importance of local POCUS champions who can provide more hands-on and longitudinal support. Come hear about our lessons learned!