Quality control of B-lines analysis in stress Echo 2020 View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-12

AUTHORS

Maria Chiara Scali, Quirino Ciampi, Eugenio Picano, Eduardo Bossone, Francesco Ferrara, Rodolfo Citro, Paolo Colonna, Marco Fabio Costantino, Lauro Cortigiani, Antonello D’. Andrea, Sergio Severino, Claudio Dodi, Nicola Gaibazzi, Maurizio Galderisi, Andrea Barbieri, Ines Monte, Fabio Mori, Barbara Reisenhofer, Federica Re, Fausto Rigo, Paolo Trambaiolo, Miguel Amor, Jorge Lowenstein, Pablo Martin Merlo, Clarissa Borguezan Daros, José Luis de Castro e Silva Pretto, Marcelo Haertel Miglioranza, Marco A. R. Torres, Clarissa Carmona de Azevedo Bellagamba, Daniel Quesada Chaves, Iana Simova, Albert Varga, Jelena Čelutkienė, Jaroslaw D. Kasprzak, Karina Wierzbowska-Drabik, Piotr Lipiec, Paulina Weiner-Mik, Eva Szymczyk, Katarzyna Wdowiak-Okrojek, Ana Djordjevic-Dikic, Milica Dekleva, Ivan Stankovic, Aleksandar N. Neskovic, Angela Zagatina, Giovanni Di Salvo, Julio E. Perez, Ana Cristina Camarozano, Anca Irina Corciu, Alla Boshchenko, Fabio Lattanzi, Carlos Cotrim, Paula Fazendas, Maciej Haberka, Bozena Sobkowic, Wojciech Kosmala, Tomasz Witkowski, Piotr Gosciniak, Alessandro Salustri, Hugo Rodriguez-Zanella, Luis Ignacio Martin Leal, Alexandra Nikolic, Suzana Gligorova, Madalina-Loredana Urluescu, Maria Fiorino, Giuseppina Novo, Tamara Preradovic-Kovacevic, Miodrag Ostojic, Branko Beleslin, Bruno Villari, Michele De Nes, Marco Paterni, Clara Carpeggiani, on behalf of Stress Echo 2020 study group of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI)

ABSTRACT

BACKGROUND: The effectiveness trial "Stress echo (SE) 2020" evaluates novel applications of SE in and beyond coronary artery disease. The core protocol also includes 4-site simplified scan of B-lines by lung ultrasound, useful to assess pulmonary congestion. PURPOSE: To provide web-based upstream quality control and harmonization of B-lines reading criteria. METHODS: 60 readers (all previously accredited for regional wall motion, 53 B-lines naive) from 52 centers of 16 countries of SE 2020 network read a set of 20 lung ultrasound video-clips selected by the Pisa lab serving as reference standard, after taking an obligatory web-based learning 2-h module ( http://se2020.altervista.org ). Each test clip was scored for B-lines from 0 (black lung, A-lines, no B-lines) to 10 (white lung, coalescing B-lines). The diagnostic gold standard was the concordant assessment of two experienced readers of the Pisa lab. The answer of the reader was considered correct if concordant with reference standard reading ±1 (for instance, reference standard reading of 5 B-lines; correct answer 4, 5, or 6). The a priori determined pass threshold was 18/20 (≥ 90%) with R value (intra-class correlation coefficient) between reference standard and recruiting center) > 0.90. Inter-observer agreement was assessed with intra-class correlation coefficient statistics. RESULTS: All 60 readers were successfully accredited: 26 (43%) on first, 24 (40%) on second, and 10 (17%) on third attempt. The average diagnostic accuracy of the 60 accredited readers was 95%, with R value of 0.95 compared to reference standard reading. The 53 B-lines naive scored similarly to the 7 B-lines expert on first attempt (90 versus 95%, p = NS). Compared to the step-1 of quality control for regional wall motion abnormalities, the mean reading time per attempt was shorter (17 ± 3 vs 29 ± 12 min, p < .01), the first attempt success rate was higher (43 vs 28%, p < 0.01), and the drop-out of readers smaller (0 vs 28%, p < .01). CONCLUSIONS: Web-based learning is highly effective for teaching and harmonizing B-lines reading. Echocardiographers without previous experience with B-lines learn quickly. More... »

PAGES

20

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12947-018-0138-7

DOI

http://dx.doi.org/10.1186/s12947-018-0138-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1106216870

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30249305


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