Consensus on focused cardiac ultrasound: The beginning of a promising friendship

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Torres Macho, A. Zapatero Gaviria, G. García de Casasola" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Torres Macho" "email" => array:1 [ 0 => "jtorresmacho@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Zapatero Gaviria" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "G." "apellidos" => "García de Casasola" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:1 [ "colaborador" => "en representación del grupo de trabajo de Ecografía Clínica de la Sociedad Española de Medicina Interna" ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Consenso sobre ecocardioscopia: el comienzo de una prometedora amistad" ] ] "textoCompleto" => "Recently, the Revista Española de Cardiología (Spanish Journal of Cardiology) published the consensus document developed by the Spanish Society of Internal Medicine (SEMI), the Spanish Society of Family and Community Medicine (SEMFYC), the Spanish Society of Neurology (SEN) and the Spanish Society of Cardiology (SEC) on echocardiography in Spain.<a class="elsevierStyleCrossRef" href="#bib0025">1</a> This document was the fruit of several years of work to reach a firm and sustained understanding among the various societies. The use of ultrasonography by physicians of specialties other than the traditional, mainly radiology, cardiology and gynecology, has created conflicts. One of the keys for bringing this consensus to fruition is that there was a common objective: extending the use of this technique to benefit more patients. However, it is important to promote standardized and appropriate training for all practitioners.The initial approach by boards of directors was a key point for establishing a specific workgroup. This institutional collaboration has generated this and other initiatives of considerable importance and future interest such as the proposal for the shared organization of new care models for patients with heart failure in terms of heart failure programs and units.Once the workgroup was created, one of the first issues to be debated was the term to use for defining this type of examination, given that it should be differentiated from focused ultrasonography. Although we at SEMI consider that the term echocardiography is not the most optimal and while other terms were considered, we ultimately opted for this term because it was the one SEC had been using in previous official publications.What is the importance of this document? Beyond proposing a joint theoretical-practical training strategy between cardiology and the other specialties, the document lays the foundation for developing a close collaboration between the various departments in the setting of clinical ultrasonography. There are still centers where difficulties arise with the cardiology department due to the use of ultrasound in cardiac evaluations by noncardiologists. This document should be seen as a first step to resolving this disagreement and implementing a cultural change that helps cardiologists become participants in our initial training and establish a relationship of close and continuous coordination over time. This collaboration can be bidirectional, given that as internists we can help the cardiology department incorporate ultrasound examinations of other territories of considerable usefulness for patients with cardiovascular problems, examinations such as pulmonary ultrasonography and peripheral vascular ultrasonography.This consensus contains shared basic lines with previous documents developed jointly by various societies both in the US and Europe,<a class="elsevierStyleCrossRefs" href="#bib0030">2,3</a> with the feature of establishing the foundations of a joint educational pathway, a situation we consider optimal.At this time, each society is in a different situation in terms of implementing the generalized use of echocardiography. Internal medicine departments are prepared to establish training centers in coordination with the cardiac imaging sections of their respective centers (the ideal situation) or others that serve as the reference for completing the students’ practical rotations. In the coming months, we will be working intensely to identify these training centers and ensure that they are accessible for the maximum number of practitioners.This document supplements the positioning document of SEMI on clinical ultrasonography, recently published in Revista Clínica Española.<a class="elsevierStyleCrossRef" href="#bib0040">4</a> Given that clinical ultrasonography will be included in the specialty's next official training program, the Clinical Ultrasonography Workgroup (in conjunction with SEMI) will develop, in the coming months, a specific accreditation program in general clinical ultrasonography. We will ensure that the accreditation in echocardiography is a supplementary curricular element that can be obtained synchronously with the general accreditation.The patient-centered medicine of the 21st century has shown the importance of having our organizations provide care based on multidisciplinary coordination and continuity of care, using all the resources and tools at our disposal. Echocardiography is a paradigmatic example of this principle, and, despite the substantial work ahead, the first crucial step has been taken.In conclusion, we would like to thank the various societies for setting their sights high, for their willingness to come to an agreement and for joining us in this challenge that will enable us to improve our patients’ care." 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García de Casasola Sánchez" 4 => "T. López Fernández" 5 => "I.M. Sánchez Barrancos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2018.05.039" "Revista" => array:4 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2018" "paginaInicial" => "pii:S1885" "paginaFinal" => "pii:S5857" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.J. Labovitz" 1 => "V.E. Noble" 2 => "M. Bierig" 3 => "S.A. Goldstein" 4 => "R. Jones" 5 => "S. Kort" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Soc Echocardiogr" "fecha" => "2010" "volumen" => "12" "paginaInicial" => "1225" "paginaFinal" => "1230" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Focus cardiac ultrasound core curriculum and core syllabus of the European Association of Cardiovascular Imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.N. Neskovic" 1 => "H. Skinner" 2 => "S. Price" 3 => "G. Via" 4 => "S. de Hert" 5 => "I. Stankovic" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ehjci/jey006" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J Cardiovasc Imaging" "fecha" => "2018" "volumen" => "19" "paginaInicial" => "475" "paginaFinal" => "481" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29529170" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Documento de posicionamiento sobre la incorporación de la ecografía clínica en los servicios de Medicina Interna" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Torres Macho" 1 => "F.J. García Sánchez" 2 => "P. Garmilla Ezquerra" 3 => "L. Beltrán Romero" 4 => "J. Canora Lebrato" 5 => "J.M. Casas Rojo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2018.02.001" "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2018" "volumen" => "218" "paginaInicial" => "192" "paginaFinal" => "198" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29519537" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021900000001/v1_201901300620/S225488741830167X/v1_201901300620/en/main.assets" "Apartado" => array:4 [ "identificador" => "71813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Correspondence" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021900000001/v1_201901300620/S225488741830167X/v1_201901300620/en/main.pdf?idApp=WRCEE&text.app=https://www.revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225488741830167X?idApp=WRCEE"]

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