Background Ultrasonography is increasingly being used in primary care settings, facilitated by technological advancements, reduced device-related costs, and improved access to training and support. It holds particular promise for underserved communities, where barriers such as co-pays or long waiting lists can limit access to diagnostic services. This study evaluates the impact of a primary care ultrasonography service in an underserved urban community.

Methods We conducted a retrospective cohort study of consecutive patients who underwent ultrasonography between 2019-2024 at a large primary care center (n=7877 patients) in Amsterdam the Netherlands. The primary outcomes included the frequency, indications, and diagnostic outcomes. Secondary outcomes included diagnostic accuracy, changes in clinical decision-making, referral rates, and costs.

Results A total of 394 patients were included, of whom 62.4% underwent abdominal ultrasonography, 31.7% gynecological ultrasonography, and 5.8% other types of ultrasounds. Ultrasonography yielded conclusive results in 83.5% of cases, and reduced secondary care referrals by 58.8%. The sensitivity and specificity for ultrasonographic abnormalities were 98.9% (95%CI: 94.2-99.9%) and 89.8% (95%CI: 85.3-93.4%), respectively.

Conclusion Primary care ultrasonography enhances diagnostic efficiency and reduces unnecessary referrals in more than half of cases. Its use in underserved communities can improve healthcare access and help address system-related health disparities. Further research is needed to assess its cost-effectiveness and scalability.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Medical Ethics Committee of Amsterdam UMC (MEC-AMC) reviewed the study and concluded that it does not fall under the scope of the Dutch Medical Research Involving Human Subjects Act (WMO). As such, the use of deidentified routine primary care data for research purposes was granted a waiver for ethical approval and informed consent (Reference: W23_074, MEC-AMC, Amsterdam).

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Data produced in the present study are available upon reasonable request to the authors