The integration of ultrasound (echography) into primary care has emerged as a promising innovation to enhance diagnostic accuracy, reduces unnecessary additional examinations, and improves patient-doctor trust.This study evaluates the impact of echography on consultation lenght, post-consultation recommendations, and the need for additional examinations.A multicentric prospective survey was conducted in the Drôme-Ardèche region of Southern France, involving 18 general practitioners,  9 in the echoclinic group (ECG)  and 9 in the stethoclinic group (SCG ).The ECG received a 3 day training program on the use of the V-Scan Extend Dual Dicom Ultrasound device. A total of 166 patients were included, with 124 in the ECG and 42 in the SCG. Eight clinical scenarios were evaluated, focusiong on consultation lenght, the number of additional examinations required, and the alignement between doctor's recommendations and patients' subsequent actions.The average consultation lenght was 17,5 minutes in both groups, indicating that the use of echography did not prolong  consultations. The ECG demonstrated a higher rate of agreement (83%) between doctors'  recommandations and patients' actions  compared to the SCG (69%). The use of echography reduced the need for additional examinations in 65%of cases, compared to 29% in the SCG. It suggests that echography enhances diagnostic precision and strengthens  the patient-doctor relatioship.The study highlights echography to streamline primary care by reducing diagnostic tests and improving patient adherence to medical advice. The abscence of increased consultation time adresses a common concern. Furthermore, the integration of echographyinfo medical training could foster greater confidence  and competence among general practitioners, ultimately leading to better patient outcomes.Echography is a valuable tool in primary care, offering significant benefits in terms of diagnostic efficiency, cost reduction, and patient satisfaction. Its incorporaton into medical curricula and routine pratice could transform prmary care delivery, particularly in resource-limited settings. This study underscores the need for broader adoption of echography in general practice .

Abdominal aortic aneurysm (AAA) is an uncommon, yet potentially fatal condition due to its high mortality rate in the event of rupture. To ensure timely detection, several countries have introduced organised, invitation-based national screening programmes. In Hungary, such institutionalised and targeted screening is not yet available.The aim of our multiregional validation pilot study was to assess the feasibility and justification of implementing AAA screening within Hungarian primary care.Following a brief practical training, ten general practitioners (GPs) joined the pilot screening programme. Point-of-care ultrasound recordings obtained during screening were validated by radiologists. Screening was offered to men aged 65–75 years irrespective of smoking status, as well as to men and women over 50 years of age with a personal or family history of aneurysmal arterial disease.To date, 309 screening examinations have been performed across five counties in Hungary. During the validation process, only six image sequences (1.98%) were deemed non-assessable. Among the 303 patients with valid examinations (mean age 69.5±3.1 years; 97.7% male; 21.8% current smokers), infrarenal AAA was identified in eight individuals, yielding a period prevalence of 2.64%. Three patients have since undergone vascular surgery. The mean examination time recorded during screenings conducted by GPs was 6.7±4.0 minutes.Introducing AAA screening into Hungarian primary care appears to be an efficient strategy for early detection. GPs are well positioned to reach the target population, and the low rate of non-assessable examinations suggests that the diagnostic process is feasible following brief training. Nevertheless, the overall success of such a screening programme depends heavily on the quality of training, the availability of resources, sustainable financing structures, and the maintenance of diagnostic accuracy.These preliminary findings demonstrate that abdominal aortic aneurysm screening integrated into Hungarian primary care is both feasible and potentially clinically valuable, supporting further evaluation of its long-term effectiveness, cost-efficiency, and nationwide implementability.

Focused cardiac ultrasound (FOCUS) enhances cardiac assessment in primary care but is operator-dependent. AI integration may improve accuracy, reproducibility, and early detection.We aimed to evaluate the diagnostic performance of AI-assisted FOCUS (AI-FOCUS) performed by trained family physicians against blinded cardiologist-performed echocardiography.We conducted a prospective, observational cross-sectional study in primary care in Romania (N = 1780; age 40–75 years). Patients had high cardiovascular risk (SCORE2-OP ≥10%) or symptoms suggestive of cardiac pathology. Exclusion criteria included prior cardiovascular disease, morbid obesity, and inadequate acoustic windows. Family physicians performed conventional FOCUS and AI-FOCUS using a Sonoscape-P60 system with Wis+ AI. Target endpoints were LVEF <50%, screening-level valvular abnormalities, and pericardial effusion. The reference standard was blinded cardiologist echocardiography within 24 h. Diagnostic performance was assessed with accuracy, sensitivity, specificity, PPV, NPV, and Cohen’s κ. Five-fold cross-validation confirmed reproducibility.AI-FOCUS achieved 94.3% accuracy (95% CI 93.2–95.4), 89.9% sensitivity, 96.5% specificity, PPV 92.6%, NPV 95.1%, with excellent agreement (κ = 0.88). Cardiac abnormalities were present in 32.9%: valvular disease (42%), LVEF <50% (28%), and pericardial effusion (12%). AI-assisted LVEF <50% (OR = 6.05, p < 0.0001) and valvular abnormalities (OR = 4.05, p < 0.0001) were independent predictors of cardiac pathology. Diagnostic accuracy was consistently high across age, sex, and cardiovascular risk strata. It reliably detected LVEF < 50%, valvular disease, and pericardial effusion, supporting early triage and referral in primary care.AI-FOCUS substantially reduces operator dependency and allows standardized cardiac assessment in primary care. Its high reproducibility supports early detection, risk stratification, and timely referral while minimizing unnecessary specialist visits.AI-assisted FOCUS is a scalable and reliable tool for primary care cardiovascular screening, enabling early diagnosis of systolic/dyastolic dysfunction, valvular disease, and pericardial effusion. Integration into routine practice and telemedicine optimizes patient outcomes and efficiency in resource-limited settings.

Early detection of prostate cancer in primary care remains challenging because PSA and Free PSA lack sufficient specificity, often leading to unnecessary specialist referrals. Multiparametric ultrasound (mp-US)—including elastography, microflow imaging, Doppler vascularity, prostate volume assessment, and structured PIRADS interpretation—offers a more accessible alternative to multiparametric MRI. Strengthening diagnostic capability at the primary care level promotes equity, timely triage, and patient-centred decision-making aligned with the principles of general practice.To evaluate the diagnostic performance of mp-US parameters combined with PSA, Free PSA, and PSA density (PSAD) for identifying high-risk prostate lesions, and to assess agreement between family physicians and urologists in biopsy decision-making.Among 400 eligible men screened in primary care, 167 patients with abnormal PSA, lower urinary tract symptoms, or MP-US findings were included. Age ranged 26–94 years (median 65). Risk stratification incorporated PIRADS score, elastography (hard stiffness), microflow assessment, Doppler vascularity, PSA, Free PSA, prostate volume, and PSAD. Analyses included descriptive statistics, ANOVA across PIRADS groups, correlation tests, multivariate logistic regression, ROC analysis, age-stratified risk, and Cohen’s kappa for inter-rater reliability.Most patients were aged 55–79 years (66%). PSA and Free PSA differentiated risk groups: normal (PSA 3.2 ng/mL, Free PSA 28%), BPH/moderate risk (5.8 ng/mL, 16%), and high-risk (10.2 ng/mL, 10%). PSAD increased progressively across PIRADS categories (p<0.001). Hard stiffness appeared in 50% of PIRADS 3 and 100% of PIRADS 4–5 lesions. Strong correlations were observed between PSAD and PIRADS (r=0.62) and between elastography and microflow (r=0.48). Independent predictors of high-risk lesions included: PIRADS 4–5 (OR 12.5), PSAD (OR 8.2), elastography (OR 3.1), microflow (OR 2.7), and Doppler score (OR 1.6). ROC analysis showed excellent accuracy for the combined model (AUC 0.94; sensitivity 92%, specificity 87%). Agreement between GPs and urologists improved from κ=0.48 to κ=0.82 after integrating mp-US and PSAD.MP-US features significantly enhance diagnostic precision compared to PSA-based assessment alone. The combined model supports more consistent triage decisions and reduces unnecessary referrals.Multiparametric ultrasound integrated with PSA density enables accurate identification of high-risk prostate pathology in primary care and substantially improves urologist agreement, offering an equitable and accessible approach to early detection.

Point-of-care ultrasonography (POCUS) is increasingly used in primary care, yet evidence on the diagnostic accuracy of gallbladder ultrasonography performed by general practitioners (GPs) remains limited. Gallbladder disease is a frequent cause of abdominal pain, and rapid bedside assessment may improve triage and reduce delays in management.To determine the diagnostic accuracy of gallbladder POCUS performed by trained GPs in detecting cholecystolithiasis, compared with expert abdominal ultrasound examination.This cross-sectional diagnostic accuracy study included consecutive adult patients presenting to GP practices with symptoms suggestive of biliary disease. All participating GPs completed standardized POCUS training. POCUS evaluation included gallstone detection, gallbladder wall assessment and presence of sludge. Expert ultrasound served as the reference standard. Sensitivity, specificity, likelihood ratios, predictive values and accuracy for solitary, multiple and overall cholecystolithiasis were calculated.Forty-three patients were enrolled; in 42 cases (97.7%) the gallbladder was successfully visualised. Mean age was 53.3±15.4 years and 71.4% were women. Right upper quadrant pain was present in 78.7% and a positive Murphy sign in 11.9% of patients. POCUS identified solitary gallstones in 33.3%, multiple gallstones in 19.0% and sludge in 14.3% of patients. Mean examination time was 263±190 seconds, significantly shorter in fasting patients (195±135 s vs 315±212 s; p=0.042). Diagnostic performance for any cholecystolithiasis showed sensitivity 95.45% (95% CI 77.16–99.88), specificity 95.00% (75.13–99.87). For solitary gallstones, sensitivity was 78.57% and specificity 100%, for multiple gallstones sensitivity reached 100% and specificity 91.18%.POCUS of the gallbladder performed by trained GPs displayed high diagnostic accuracy, consistent with previously reported results from emergency medicine and hospital settings. Examination was rapid and feasible during routine consultations. The lower sensitivity for solitary stones may reflect small size or difficult anatomical windows, whereas multiple stones were more readily visualised. These real-world data suggest that GP-performed POCUS can accelerate diagnostic pathways and may help reduce delays for specialist imaging.General practitioners, after structured training, can accurately identify cholecystolithiasis using POCUS. Integrating gallbladder ultrasound into routine primary care practice has the potential to improve diagnostic efficiency and patient management. Further multicentre studies with larger cohorts are warranted to confirm these findings.

Deep vein thrombosis (DVT) is a major public health issue due to its morbidity and mortality. Diagnosis typically relies on venous Doppler ultrasound performed by specialists, but long waiting times can delay management and prompt empirical anticoagulation. Point-of-care ultrasound by general practitioners (GPs) could streamline patient care by reducing diagnostic delays and avoiding unnecessary treatments.To evaluate the ability of French GPs equipped with ultrasound to confirm or exclude DVT in daily practice and to describe their diagnostic and management approaches.A national prospective observational study was conducted among GPs using ultrasound in primary care. For each patient with suspected DVT, practitioners completed a questionnaire recording clinical probability, ultrasound results, anticoagulant prescriptions, and referrals. Statistical analysis was performed with a significance threshold of p<0.05.Sixty-one cases were included. Ultrasound confirmed DVT in 36.1%, excluded it in 60.7%, and was inconclusive in 3.3%. Venous incompressibility was present in all confirmed cases. In 56.4% of negative or uncertain cases, an alternative diagnosis was found, mostly musculoskeletal disorders. Anticoagulant prescriptions were strongly correlated with ultrasound findings (p<0.01). Additional investigations and specialist referrals remained limited.Ultrasound performed by GPs enabled rapid diagnostic clarification, reducing delays and the need for empirical anticoagulation. Its integration into routine practice could improve care pathways, though diagnostic accuracy should be compared with specialist Doppler ultrasound.Ultrasound performed by GPs appears to be an efficient diagnostic tool for suspected DVT. It supports timely decision-making, optimises anticoagulant use, and helps identify alternative diagnoses. Further comparative studies with reference imaging are required to validate its diagnostic accuracy and support broader implementation in primary care.

Point-of-care ultrasound (POCUS), referred to in France as échographie clinique ciblée (ECC), is defined as an ultrasound examination integrated into clinical evaluation to rapidly address focused diagnostic questions. Its rapid expansion contrasts with the limited national data describing its real-world use and with the absence of formal recommendations supporting its implementation in general practice.The primary objective was to describe POCUS use in terms of frequency, duration, organs explored, indications, and perceived image quality. Secondary objectives assessed changes in diagnostic hypotheses, patient orientation, and treatment.A prospective, multicentre observational study was conducted among GPs performing POCUS in private practices, health centres, and during home visits. Data were collected between 2023 and 2024 during a one-month inclusion period. For each POCUS examination, GPs completed an online questionnaire before and after POCUS. All patients who underwent a POCUS examination were eligible for inclusion, except minors and patients who declined participation. Ethical approval was obtained.Thirty-seven GPs from 11 French regions participated. They owned fixed (62%), portable (32%), or ultraportable (41%) devices; curvilinear and superficial probes were most frequently used. Participants had a median POCUS experience of 5 years and had completed a median of 3 training programs. A total of 655 patients were included. GPs used POCUS a median of 1.6 times per day. Median examination duration was 7 minutes. The main anatomical areas explored were the abdomen (24%), urinary tract (24%), musculoskeletal system (22%), and gynecological–obstetrical area (19%). GPs to obtained relevant findings in 95% of examinations. The primary indication for POCUS was answering a focused clinical question (88%). Single diagnostic hypotheses increased from 33.4% to 77.5% after POCUS. Diagnostic hypotheses changed in 68.8% of cases, imaging referrals in 40.4%, and the overall care pathway in 85.3%.POCUS provided rapid, clinically meaningful information, improving diagnostic clarity and informing management decisions. Its short duration demonstrates strong feasibility in general practice.POCUS substantially influences diagnostic pathways and management decisions in French general practice. These findings highlight its growing role in frontline care and reinforce the need for national guidelines and structured training pathways to support safe, effective, and widespread adoption.