Hand-held ultrasound devices

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Topic Status Complete

Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure, in the community or primary care setting.

Outcome of the appraisal


Hand-held ultrasound devices (HUDs) show promise in the diagnosis of heart failure in a primary care or community setting, but the current evidence is insufficient to support routine adoption. HUDs have the potential to reduce secondary care referrals if heart failure is excluded and to facilitate earlier treatment if confirmed, but convincing evidence is needed to substantiate any clinical and system benefits.

HTW recommends further research to investigate the benefits of implementing HUDs in a primary care or community setting in Wales; see Guidance for more information.

Why was this topic appraised?


Heart failure is a common and serious condition that is exerting an increasing burden on cardiology and heart imaging services in Wales. The diagnosis of heart failure can be suspected from clinical assessment and biochemical testing but the use of cardiac ultrasound (echocardiography) is pivotal to either confirming or excluding the diagnosis. Echocardiography is usually done in a hospital setting, but the use of hand-held ultrasound devices means that it can be offered as a quick and portable test to people in a primary care or community setting. This might enable earlier and improved patient management and avoid the need for hospital referral in some cases.

Plain language summary


HTW has assessed hand-held ultrasound devices, to help NHS Wales decide whether to use these products in day-to-day community care settings.

Heart failure is a common condition in Wales, with over 33,000 people who have been diagnosed with heart failure by their GP.

Hand-held ultrasound devices are small, “pocket-sized” machines that can be used to visualise heart structure and function. They can help decide whether people who have symptoms of heart failure, such as breathlessness, need to be referred to cardiology for further tests.

There isn’t enough evidence to recommend hand-held ultrasound devices in primary or community care. HTW recommends more research in Wales that uses hand-held ultrasound devices in day-to-day community care.

Topic Exploration Report

TER014 04.2019

Evidence Appraisal Review

EAR009 05.2019


GUI009 05.2019

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