학술논문
Quality control of B-lines analysis in stress Echo 2020
Document Type
article
Author
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)
Source
Cardiovascular Ultrasound, Vol 16, Iss 1, Pp 1-9 (2018)
Subject
Language
English
ISSN
1476-7120
Abstract
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