The State of Cardiovascular Resources and Expertise in Echocardiography Nationwide: The Philippine Survey on Echocardiography (The PHIL-SCREEN Study)
Abstract
INTRODUCTION: Maldistribution of echocardiographic expertise is a relevant issue in an archipelago such as the Philippines. We specifically looked at (1) the nationwide census of physician echocardiographers, cardiac sonographers, and cardiac laboratory managers; (2) their geographic distribution; and (3) background training and laboratory classification.
METHODS: Data from paper and online surveys conducted in 2015 and 2021 were consolidated alongside the existing society database. Surveys (Google Forms; Google, Mountain View, California) were disseminated through a variety of online, social media, and communication avenues and focused on three categories of respondents: (1) physician echocardiographers, (2) cardiac sonographers, and (3) laboratory managers. The main variables of interest included estimated census per category and geographical distribution. Secondary variables included training background and laboratory classification.
RESULTS: In 2021, there were 651 physician echocardiographers, 2487 cardiac sonographers, and 443 cardiac laboratory managers on record, with 86 readers, 405 sonographers, and 101 managers responding to the survey. The majority of the surveyed readers (41.2%), sonographers (48.3%), and laboratory managers (28.2%) were situated in the National Capital Region. Close to half of the readers were level III echocardiographers. The majority of the sonographers (46.7%) were nurses, followed by medical technologists (21.8%) and radiologic technologists (18.9%). Most laboratory managers were in nontraining hospitals (38.2%) or stand-alone facilities (20.9%). The minority were in hospitals with cardiology (18.2%) or internal medicine (22.7%) training programs.
CONCLUSION: Geographical maldistribution of echocardiographic resources is still evident, with the majority of human resources being concentrated in the metropolis. The majority of the sonographers have nursing as their training background, and many laboratory managers are situated in facilities with no established training programs.
KEYWORDS: echocardiography, laboratory, reader, resources, sonographer, survey
- Leading causes of mortality. Department of Health, Republic of the Philippines website [Internet]. Manila, Philippines. https://doh.gov.ph/Statistics/Leading-Causes of-Mortality. Accessed May 5, 2022
- Causes of deaths in the Philippines (preliminary): January to June 2021. Philippine Statistics Authority [Internet]. https:// psa.gov.ph/content/causes-deaths-philippines-preliminary january-june-2021. Accessed May 5, 2022.
- The top 10 causes of death. World Heart Organization website [Internet]. https://www.who.int/news-room/fact sheets/detail/the-top-10-causes-of-death#:~:text=The%20 top%20global%20causes%20of,birth%20asphyxia%20 and%20birth%20trauma%2C. Accessed May 5, 2022.
- Qureshi NQ, Mufarrih SH, Bloomfield GS, et al. Disparities in cardiovascular research output and disease outcomes among high-, middle- and low-income countries—an analysis of global cardiovascular publications over the last decade (2008–2017). Glob Heart 2021;16(1):4. doi: 10.5334/gh.815.
- Magno JD, Santos RJ, Cuyco RE, et al. Updates on the First Philippine Echocardiography Survey. Technical Working Group on Research and Guideline Development of the Philippine Heart Association Council on Echocardiography and Philippine Society of Echocardiography. Presented at the 47th Annual Convention of the Philippine Heart Association; Manila, Philippines; May 2015.
- Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzche PC, Vandenbroucke JP, STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008;61(4):344–349.
- Abelardo NS, Punzalan FE, Gloria FP, et al. Task Force for Core Curriculum Guidelines of the Specialty Board of Adult Cardiology and Philippine College of Cardiology/Philippine Heart Association. 2015–2016 Philippine Core Curriculum for Specialty Training in Adult Cardiology. Philippine Heart Association, Inc. 2016.
- Waggoner AD, Skelly AC. The profession of cardiac sonography and the status of professionalization of cardiac sonographers. J Am Soc Echocardiogr 1999;12:335–342.
- Nicastro I, Barletta V, Conte L, et al. Professional education, training and role of the cardiac sonographer in different countries. J Cardiovasc Echogr 2013;23(1):18–23. doi: 10.4103/2211-4122.117981.
- Althubaiti A. Information bias in health research: definition, pitfalls, and adjustment methods. J Multidiscip Healthc 2016;9:211–217. doi: 10.2147/JMDH.S104807.
- Lavrakas PJ. Response bias. Encyclopedia of Survey Research Methods 2008. https://dx.doi.org/10.4135/9781412963947.n486.
- Research ethics: does your research require ethics approval? [published online January 1, 2011] [Internet]. Manchester: The University of Manchester. https://www. staffnet.manchester.ac.uk/rbe/ethics-integrity/ethics/ ethical-approval. Accessed May 7, 2022.
- Abanilla JM, Magno JDA, Locnen SAR, et al. Philippine Core Curriculum Guidelines for Subspecialty Training in Adult Echocardiography. A report of the 2016 Task Force for Guidelines on Specialty Training in Adult Echocardiography commissioned by the Joint Committee on Accreditation, the Philippine Heart Association Council on Echocardiography, Philippine Society of Echocardiography, and the Philippine College of Cardiology Specialty Board of Adult Cardiology. Philippine Society of Echocardiography website. https://www.philechosoc.org/ education/core-curriculum.
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