TY - JOUR
T1 - Quality control of regional wall motion analysis in stress Echo 2020
AU - on behalf of Stress Echo 2020 study group of the Italian Society of Cardiovascular Echography
AU - Ciampi, Quirino
AU - Picano, Eugenio
AU - Paterni, Marco
AU - Daros, Clarissa Borguezan
AU - Simova, Iana
AU - de Castro e Silva Pretto, José Luis
AU - Scali, Maria Chiara
AU - Gaibazzi, Nicola
AU - Severino, Sergio
AU - Djordjevic-Dikic, Ana
AU - Kasprzak, Jaroslaw D.
AU - Zagatina, Angela
AU - Varga, Albert
AU - Lowenstein, Jorge
AU - Merlo, Pablo Martin
AU - Amor, Miguel
AU - Celutkiene, Jelena
AU - Perez, Julio E.
AU - Di Salvo, Giovanni
AU - Galderisi, Maurizio
AU - Mori, Fabio
AU - Costantino, Marco Fabio
AU - Massa, Laura
AU - Dekleva, Milica
AU - Chaves, Daniel Quesada
AU - Trambaiolo, Paolo
AU - Citro, Rodolfo
AU - Colonna, Paolo
AU - Rigo, Fausto
AU - Torres, Marco A.R.
AU - Monte, Ines
AU - Stankovic, Ivan
AU - Neskovic, Aleksander
AU - Cortigiani, Lauro
AU - Re, Federica
AU - Dodi, Claudio
AU - D'Andrea, Antonello
AU - Villari, Bruno
AU - Arystan, Ayana
AU - De Nes, Michele
AU - Carpeggiani, Clara
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/12/15
Y1 - 2017/12/15
N2 - Background The trial “Stress Echo (SE) 2020” evaluates novel applications of SE beyond coronary artery disease. The aim of the study was control quality and harmonize reading criteria. Methods One reader from 78 centers of the SE 2020 network asked for credentials to read a set of 20 SE video-clips selected by the core lab. All aspiring centers met the pre-requisite of high-volume and the years of experience in SE ranged from 5 to 31 years (mean value 18 years). The diagnostic gold standard was a reading by the core lab. The a priori determined pass threshold was 18/20 (≥ 90%). Results Of the initial 78 who started, 57 completed the first attempt: individual readers' score on first attempt ranged from 07/20 to 20/20 (accuracy from 35% to 100%, mean 78.7 ± 13%) and 44 readers passed it. There was a very poor correlation between years of experience and the reader's score on first attempt (r = − 0.161, p = 0.231). Of the 13 readers who failed the first attempt, 12 took it again after the web-based session and their accuracy improved (74% vs. 96%, p < 0.001). The kappa inter-observer agreement before and after web-based training was 0.59 on first attempt and rose to 0.91 on the last attempt. Conclusions In SE reading, the volume of activity or years of experience is not synonymous with diagnostic quality. Qualitative analysis and operator-dependence can become a limiting weakness in clinical practice, in the absence of strict pathways of learning, credentialing and audit.
AB - Background The trial “Stress Echo (SE) 2020” evaluates novel applications of SE beyond coronary artery disease. The aim of the study was control quality and harmonize reading criteria. Methods One reader from 78 centers of the SE 2020 network asked for credentials to read a set of 20 SE video-clips selected by the core lab. All aspiring centers met the pre-requisite of high-volume and the years of experience in SE ranged from 5 to 31 years (mean value 18 years). The diagnostic gold standard was a reading by the core lab. The a priori determined pass threshold was 18/20 (≥ 90%). Results Of the initial 78 who started, 57 completed the first attempt: individual readers' score on first attempt ranged from 07/20 to 20/20 (accuracy from 35% to 100%, mean 78.7 ± 13%) and 44 readers passed it. There was a very poor correlation between years of experience and the reader's score on first attempt (r = − 0.161, p = 0.231). Of the 13 readers who failed the first attempt, 12 took it again after the web-based session and their accuracy improved (74% vs. 96%, p < 0.001). The kappa inter-observer agreement before and after web-based training was 0.59 on first attempt and rose to 0.91 on the last attempt. Conclusions In SE reading, the volume of activity or years of experience is not synonymous with diagnostic quality. Qualitative analysis and operator-dependence can become a limiting weakness in clinical practice, in the absence of strict pathways of learning, credentialing and audit.
KW - Certification
KW - Quality control
KW - Stress echocardiography
KW - Wall motion
UR - http://www.scopus.com/inward/record.url?scp=85030458577&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2017.09.172
DO - 10.1016/j.ijcard.2017.09.172
M3 - Article
C2 - 28986062
AN - SCOPUS:85030458577
SN - 0167-5273
VL - 249
SP - 479
EP - 485
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -