Keywords: rural practice, point-of-care ultrasound, lung ultrasound, primary care, diagnostic accuracy

Background:

Point-of-care ultrasound (POCUS) is increasingly used in general practice, offering rapid bedside diagnostics. In rural areas with limited access to imaging, lung ultrasound (LUS) can enhance clinical decision-making.

Aim of the study:

Although LUS is well established in hospital settings, data on its use by rural general practitioners (GPs) are scarce. This study aimed to evaluate the diagnostic accuracy of LUS performed by GPs after brief structured training. The key question: Can GPs accurately identify lung pathology using LUS in routine primary care?

Methodology:

Adult patients with current or recent dyspnoea were consecutively enrolled. Each underwent a standardized LUS exam, with findings video-recorded and independently assessed by a blinded expert sonographer. Diagnostic accuracy was calculated for A and B profiles, consolidation, and pleural effusion.

Results:

A total of 128 patients and 768 thoracic segments were examined. Sensitivity and specificity were: A profile: 97.5% / 88.1%, B profile: 87.0% / 97.7%, Consolidation: 100% / 100%, Pleural effusion: 83.3% / 99.9%. Inter-rater agreement was substantial to almost perfect (κ = 0.85–1.00). Examinations lasted under 5 minutes and were feasible in rural primary care settings.

Conclusions:

GPs, including those in rural practices, can accurately perform LUS after short training. POCUS represents a practical, reliable tool that can expand diagnostic capacity in underserved areas and improve patient care.