Handheld echocardiography demonstrated high sensitivity and specificity in diagnosing rheumatic heart disease, outperforming traditional auscultation methods, according to a recent review.

The systematic review, published in The Lancet Global Health, assessed the diagnostic accuracy of handheld echocardiography for rheumatic heart disease (RHD) and acute rheumatic fever (ARF) in high-prevalence areas. The study aimed to inform current World Health Organization (WHO) guidelines.

Researchers analyzed 11 studies and 2 additional reports involving 15,578 participants. Results indicated that handheld echocardiography exhibited high sensitivity (0.87 [95% CI 0.76–0.93]) and specificity (0.98 [95% CI 0.71–1.00]) when compared with standard echocardiography for RHD diagnosis, with an area under the curve (AUC) of 0.94. For screening purposes, handheld devices demonstrated a sensitivity of 0.79 [95% CI 0.73–0.84] and specificity of 0.85 [95% CI 0.80–0.89], with an AUC of 0.90.

The researchers also noted handheld echocardiography outperformed auscultation, which demonstrated poor diagnostic performance, "suggesting that, when standard echocardiography is not available, handheld echocardiography might constitute a better alternative for screening and diagnosing acute rheumatic fever or rheumatic heart disease."

"This evidence synthesis will provide the basis for the new WHO guideline on the prevention and management of acute rheumatic fever and rheumatic heart disease and will potentially change the management of patients with these conditions, contributing to better outcomes," they noted.

Researchers also mentioned that future research should focus on the cost-effectiveness, long-term outcomes, and performance of advanced handheld echocardiography devices in high-prevalence regions.

This study was funded by the World Health Organization. The authors declared no competing interests.