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When Good Enough isn’t Good Enough

The Corner Office

Wayne Moore


At a recent ultrasound medical conference that I attended I actually heard a speaker, a Medical Doctor, say that the 2D image produced by a low priced hand-held ultrasound unit was “good enough” for the clinical application he was using it for (calculating cardiac ejection fraction). He said this in response to questions that came up during the session concerning the image quality of a low-priced hand-held device versus that produced by an expensive cart-based ultrasound system. His position was that audience members were comparing good-enough images with “pretty images”. As a Fellow of the American Society of Echocardiography, and published author in several cardiac journals, I was taken back by his comment.  I must have missed the memo that said “good enough” is “good enough” in medical imaging. And slurring diagnostic quality images as merely “pretty” Images was a bit over the top. I have been in the field of echocardiography for more than 40 years as an engineer focused on clinical investigation and ultrasound product development. In the early 1980s we knew we were missing early disease process with the ultrasound devices we were using as well as missing things we didn’t know we were missing such as a small mural thrombus at the apex of the left ventricular wall (see image above): We knew we had to make the images better, more diagnostic, not “prettier”. Now in 2023 high-end cart-based ultrasound systems produce such high-quality diagnostic images that we are catching disease process during a routine or clinically focused exam that simply would not have been possible 40 years ago, or even 10 years ago. Using a low-priced hand-held device should not mean sacrificing the fidelity of the ultrasound image by setting such a low bar as “good enough”. Not all manufacturers of hand-held devices agree with the “good enough” paradigm and have designed their systems to produce contemporary high quality diagnostic images. They understand that the enemy of best is good. Don’t settle.


Until Next Month,

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May 23, 2023 Newsletter