Hans-Christian Myklestul

• Myklestul, Hans-Christian; Skjeie, Holgeir; Brekke, Mette & Skonnord, Trygve (2024). ‘Shades of grey’: a focus group study on diagnostic uncertainty among general practitioners using point-of-care ultrasound. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. doi: 10.1080/02813432.2024.2423242. Fulltekst i vitenarkiv Vis sammendrag

  Background Point-of-care ultrasound (POCUS) has long been a diagnostic tool in family medicine, although most Norwegian general practitioners (GPs) who use POCUS, scans infrequently. The broad scope of family medicine, the relatively low prevalence of illnesses and infrequent use of POCUS imply that GPs may experience diagnostic uncertainty regularly. Aim To explore how GPs perceived and managed diagnostic uncertainty when using POCUS. Design and setting A qualitative focus group study among Norwegian GPs using POCUS. Methods Four focus group discussions were conducted. Total number of participants were 21. The interview guide was piloted, the focus group discussions were audio-recorded and transcribed, and Systematic Text Condensation, a thematic cross-case analysis, was used to analyse the data. Results Diagnostic uncertainty using POCUS was considered as aligning to the general clinical uncertainties in family medicine, but there were also POCUS-specific uncertainties in clinical decision-making. We generated six themes: emotional, cognitive, and ethical uncertainty using POCUS, communicating uncertainty to patients, interaction with specialists when using POCUS, and coping strategies of participants. POCUS results were the only results the participants sometimes withheld when communicating with other specialists. POCUS itself stimulated a renewed interest in family medicine. Scanning enough patients was the recommended coping strategy. Conclusion POCUS-using GPs experienced diagnostic uncertainty when using POCUS that aligned with other diagnostic uncertainties they experienced in everyday practice. However, they did not treat the results like other findings, as the GPs at times withheld their POCUS findings when interacting with secondary care specialists. This requires further investigation.

• Myklestul, Hans-Christian; Skonnord, Trygve T. & Brekke, Mette (2020). Point-of-care ultrasound (POCUS) in Norwegian general practice. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. doi: 10.1080/02813432.2020.1753385. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To assess the use of point-of-care ultrasound (POCUS) in Norwegian general practice. Design: Retrospective register study based on general practitioners’ (GPs’) reimbursement claims. Setting: Norwegian general practice excluding out-of-hours clinics in 2009, 2012 and 2016. Subjects: GPs who scanned patients for a given set of symptoms and medical conditions. Main outcome measures: Number and characteristics of GPs performing POCUS. Number and type of scans carried out. Results: The number of scanning GPs increased from 479 in 2009 to 2078 in 2016. The number of registered scans increased from 8962 to 55921. In 2016, approximately 30% of Norwegian GPs sent at least one reimbursement claim for POCUS. Seven out of 10 GPs did not scan every month. The gender distribution of scanning GPs was equal to that of the total GP population. Male GPs scanned four times more frequent than female GPs. Specialist in family medicine scanned twice as much as non-specialist. The use of POCUS among GPs in different counties varied from 31.6 to 198.5 per 10,000 citizens. Conclusions: The number of Norwegian GPs using POCUS and the number of scans have increased substantially from 2009 to 2016. The use of the various scans, based on the use of reimbursement claims, have evolved differently. The reasons for this are not known. The low number of scans carried out by most GPs raises a concern when it comes to the quality of the performed scans.

Se alle arbeider i NVA

• Myklestul, Hans-Christian & Skonnord, Trygve (2025). Ultralyd i allmennpraksis – nyttig eller hokuspokus? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(1). doi: 10.4045/tidsskr.24.0601. Fulltekst i vitenarkiv
• Myklestul, Hans-Christian; Skonnord, Trygve; Andersen, Camilla Aakjær; Jensen, Martin Bach & Brekke, Mette (2024). Clinical impact of point-of-care ultrasound in general practice: a prospective observational study. Fulltekst i vitenarkiv
• Myklestul, Hans-Christian; Skjeie, Holgeir; Brekke, Mette & Skonnord, Trygve (2022). Fifty shades of grey and clinical uncertainty; a focus group study among general practitioners using point-of-care ultrasound as a part of clinical decision making. Fulltekst i vitenarkiv
• Myklestul, Hans-Christian (2022). RE: What is appropriate use of sonography in general practice? Annals of Family Medicine. ISSN 1544-1709. doi: 10.1370/afm.2795. Fulltekst i vitenarkiv
• Myklestul, Hans-Christian; Skjeie, Holgeir; Brekke, Mette & Skonnord, Trygve (2022). Fifty shades of grey and clinical uncertainty; Focus group study among general practitioners using point-of-care ultrasound (POCUS) as a part of clinical decision making. Fulltekst i vitenarkiv
• Myklestul, Hans-Christian; Skonnord, Trygve & Brekke, Mette (2022). Point-of-care ultrasound (POCUS) in Norwegian general practice. Fulltekst i vitenarkiv
• Mjølstad, Bente Prytz; Rønneberg, Marianne; Myklestul, Hans-Christian & Getz, Linn Okkenhaug (2020). Aftenpostens legeroman. Fulltekst i vitenarkiv
• Myklestul, Hans-Christian; Skonnord, Trygve T. & Brekke, Mette (2019). The UNG study: Ultrasound in Norwegian General practice, a prevalence study. Fulltekst i vitenarkiv
• Myklestul, Hans-Christian; Skonnord, Trygve T. & Brekke, Mette (2019). AFU-prosjektbeskrivelse. Fulltekst i vitenarkiv

Se alle arbeider i NVA