The Need for Device-Specific Training Before Handheld Ultrasound Use: Agreement and Repeatability of Simulated Aortic Aneurysm Diameter Measurements by Senior Sonography Students on a Familiar Conventional and an Unfamiliar Handheld System
- 1Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
- 2Radiology and Medical Imaging Department, College of Applied Medical Sciences in Al-Kharj, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
Abstract
Background: Ultrasound measurement of abdominal aortic aneurysm (AAA) diameter guides screening and surveillance, but whether students’ measurement competence on a conventional system transfers to an unfamiliar handheld device has rarely been assessed. Methods: Twenty-seven senior sonography students made three anteroposterior outer-to-outer measurements of two water-filled balloons embedded in gelatin (reference diameters 3.53 and 5.88 cm, calculated from the circumference before embedding), first on the familiar cart-based conventional system and then, in a fixed, non-randomised order, on a handheld system with which they had no prior hands-on experience. The primary outcomes were bias against the calculated reference, with equivalence testing (±5%), and the paired between-system difference, with Bland–Altman analysis; repeatability was assessed with repeatability coefficients. Results: Conventional measurements were equivalent to the calculated reference within ±5% (bias −0.09 cm, 95% CI −0.16 to −0.02; +0.07 cm, 95% CI −0.05 to +0.19). Handheld measurements were higher (+0.17 and +0.33 cm; both p < 0.001) and failed equivalence; the mean between-system difference was +0.26 cm (95% CI 0.18–0.34), without proportional bias. Single-reading repeatability coefficients were 0.31–0.67 cm. Conclusions: Students’ conventional-system measurements agreed closely with the calculated reference, although this reference was not verified after embedding. Because device type was confounded with operator inexperience and with a fixed testing order, which introduces an unquantifiable learning or fatigue effect, the 0.26 cm value is an observed between-system difference under the study conditions and cannot be attributed to the handheld device itself. Measurement competence did not transfer automatically to a new device, underlining the critical need for device-specific training before handheld systems are used for aortic measurement. These implications are educational and technical; phantom findings do not support clinical surveillance recommendations without confirmation in patients.
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BibTeX
@article{hassan2026need,
title = {{The Need for Device-Specific Training Before Handheld Ultrasound Use: Agreement and Repeatability of Simulated Aortic Aneurysm Diameter Measurements by Senior Sonography Students on a Familiar Conventional and an Unfamiliar Handheld System}},
author = {Mahasin G. Hassan and Dema Alenazi and Salsabil Aldosari and Alanoud Alotaibi and Rema Alrajhi and Lamis Al-Sultan and Mohammed Alsaadi},
journal = {Diagnostics},
year = {2026},
month = oct,
doi = {10.3390/diagnostics16213524},
url = {https://doi.org/10.3390/diagnostics16213524},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Need for Device-Specific Training Before Handheld Ultrasound Use: Agreement and Repeatability of Simulated Aortic Aneurysm Diameter Measurements by Senior Sonography Students on a Familiar Conventional and an Unfamiliar Handheld System
AU - Mahasin G. Hassan
AU - Dema Alenazi
AU - Salsabil Aldosari
AU - Alanoud Alotaibi
AU - Rema Alrajhi
AU - Lamis Al-Sultan
AU - Mohammed Alsaadi
PY - 2026
DA - 2026/10/01
JO - Diagnostics
DO - 10.3390/diagnostics16213524
UR - https://doi.org/10.3390/diagnostics16213524
AB - Background: Ultrasound measurement of abdominal aortic aneurysm (AAA) diameter guides screening and surveillance, but whether students’ measurement competence on a conventional system transfers to an unfamiliar handheld device has rarely been assessed. Methods: Twenty-seven senior sonography students made three anteroposterior outer-to-outer measurements of two water-filled balloons embedded in gelatin (reference diameters 3.53 and 5.88 cm, calculated from the circumference before embedding), first on the familiar cart-based conventional system and then, in a fixed, non-randomised order, on a handheld system with which they had no prior hands-on experience. The primary outcomes were bias against the calculated reference, with equivalence testing (±5%), and the paired between-system difference, with Bland–Altman analysis; repeatability was assessed with repeatability coefficients. Results: Conventional measurements were equivalent to the calculated reference within ±5% (bias −0.09 cm, 95% CI −0.16 to −0.02; +0.07 cm, 95% CI −0.05 to +0.19). Handheld measurements were higher (+0.17 and +0.33 cm; both p < 0.001) and failed equivalence; the mean between-system difference was +0.26 cm (95% CI 0.18–0.34), without proportional bias. Single-reading repeatability coefficients were 0.31–0.67 cm. Conclusions: Students’ conventional-system measurements agreed closely with the calculated reference, although this reference was not verified after embedding. Because device type was confounded with operator inexperience and with a fixed testing order, which introduces an unquantifiable learning or fatigue effect, the 0.26 cm value is an observed between-system difference under the study conditions and cannot be attributed to the handheld device itself. Measurement competence did not transfer automatically to a new device, underlining the critical need for device-specific training before handheld systems are used for aortic measurement. These implications are educational and technical; phantom findings do not support clinical surveillance recommendations without confirmation in patients.
SN - 2075-4418
ER -