Quality control of B-lines analysis in stress Echo 2020
- Autori: Scali, Maria Chiara; Ciampi, Quirino; Picano, Eugenio; Bossone, Eduardo; Ferrara, Francesco; Citro, Rodolfo; Colonna, Paolo; Costantino, Marco Fabio; Cortigiani, Lauro; Andrea, Antonello D'.; Severino, Sergio; Dodi, Claudio; Gaibazzi, Nicola; Galderisi, Maurizio; Barbieri, Andrea; Monte, Ines; Mori, Fabio; Reisenhofer, Barbara; Re, Federica; Rigo, Fausto; Trambaiolo, Paolo; Amor, Miguel; Lowenstein, Jorge; Merlo, Pablo Martin; Daros, Clarissa Borguezan; De Castro E Silva Pretto, José Luis; Miglioranza, Marcelo Haertel; Torres, Marco A. R.; De Azevedo Bellagamba, Clarissa Carmona; Chaves, Daniel Quesada; Simova, Iana; Varga, Albert; Čelutkiene, Jelena; Kasprzak, Jaroslaw D.; Wierzbowska-Drabik, Karina; Lipiec, Piotr; Weiner-Mik, Paulina; Szymczyk, Eva; Wdowiak-Okrojek, Katarzyna; Djordjevic-Dikic, Ana; Dekleva, Milica; Stankovic, Ivan; Neskovic, Aleksandar N.; Zagatina, Angela; Di Salvo, Giovanni; Perez, Julio E.; Camarozano, Ana Cristina; Corciu, Anca Irina; Boshchenko, Alla; Lattanzi, Fabio; Cotrim, Carlos; Fazendas, Paula; Haberka, Maciej; Sobkowic, Bozena; Kosmala, Wojciech; Witkowski, Tomasz; Gosciniak, Piotr; Salustri, Alessandro; Rodriguez-Zanella, Hugo; Leal, Luis Ignacio Martin; Nikolic, Alexandra; Gligorova, Suzana; Urluescu, Madalina-Loredana; Fiorino, Maria; Novo, Giuseppina; Preradovic-Kovacevic, Tamara; Ostojic, Miodrag; Beleslin, Branko; Villari, Bruno; De Nes, Michele; Paterni, Marco; Carpeggiani, Clara; Andreassi, Maria Grazia
- Anno di pubblicazione: 2018
- Tipologia: Articolo in rivista (Articolo in rivista)
- Parole Chiave: Certification; Lung comets; Quality control; Stress echocardiography; Wall motion; Echocardiography, Stress; Female; Humans; Internet; Lung; Male; Middle Aged; Pulmonary Edema; Quality Control; Radiology, Nuclear Medicine and Imaging; Cardiology and Cardiovascular Medicine
- OA Link: http://hdl.handle.net/10447/354544
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.