Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure.
Citation: Circulation. Cardiovascular imaging. 12(1):e008122, 2019 Dec. [Online 11 Jan 2019]PMID: 30632389Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Echocardiography, Doppler/st [Standards] | *Heart Diseases/dg [Diagnostic Imaging] | *Heart Ventricles/dg [Diagnostic Imaging] | *Practice Guidelines as Topic/st [Standards] | *Ventricular Function, Left | *Ventricular Pressure | Aged | Female | Heart Diseases/pp [Physiopathology] | Heart Ventricles/pp [Physiopathology] | Humans | Male | Middle Aged | Observer Variation | Predictive Value of Tests | Reproducibility of ResultsYear: 2019ISSN:- 1941-9651
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 30632389 | Available | 30632389 |
BACKGROUND: Assessment of left ventricular (LV) filling pressure is among the important components of a comprehensive echocardiographic report. Previous studies noted wide limits of agreement using 2009 American Society of Echocardiography/European Association of Echocardiography guidelines, but reproducibility of 2016 guidelines update in estimating LV filling pressure is unknown.
CONCLUSIONS: There is a good level of agreement and accuracy in the estimation of LV filling pressure using the American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 recommendations update, irrespective of the experience level of the observer.
METHODS: Echocardiographic and hemodynamic data were obtained from 50 patients undergoing cardiac catheterization for clinical indications. Clinical and echocardiographic findings but not invasive hemodynamics were provided to 4 groups of observers, including experienced echocardiographers and cardiology fellows. Invasively acquired LV filling pressure was the gold standard.
RESULTS: In group I of 8 experienced echocardiographers from the guidelines writing committee, sensitivity for elevated LV filling pressure was 92% for all observers, and specificity was 93+/-6%. Fleiss kappa-value for the agreement in group I was 0.80. In group II of 4 fellows in training, sensitivity was 91+/-2%, and specificity was 95+/-2%. Fleiss kappa-value for the agreement in group II was 0.94. In group III of 9 experienced echocardiographers who had not participated in drafting the guidelines, sensitivity was 88+/-5%, and specificity was 91+/-7%. Fleiss kappa-value for the agreement in group III was 0.76. In group IV of 7 other fellows, sensitivity was 91+/-3%, and specificity was 92+/-5%. Fleiss kappa-value for the agreement in group IV was 0.89.
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