1. Quality control of regional wall motion analysis in stress Echo 2020
- Author
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Ivan Stankovic, Bruno Villari, Jorge Lowenstein, Antonello D'Andrea, Angela Zagatina, Marco Fabio Costantino, Sergio Severino, Fausto Rigo, Maria Chiara Scali, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Iana Simova, Jelena Celutkiene, Maurizio Galderisi, Albert Varga, Rodolfo Citro, Marco Antonio Rodrigues Torres, Lauro Cortigiani, Nicola Gaibazzi, Paolo Colonna, Jarosław D. Kasprzak, Eugenio Picano, Ana Djordjevic-Dikic, Giovanni Di Salvo, Daniel Quesada Chaves, Ines Monte, Quirino Ciampi, Pablo Merlo, Fabio Mori, Clarissa Borguezan Daros, Federica Re, Paolo Trambaiolo, Julio E. Pérez, Claudio Dodi, Michele De Nes, Milica Dekleva, Aleksander Neskovic, Laura Massa, Miguel Amor, José Luis de Castro e Silva Pretto, Ciampi, Quirino, Picano, Eugenio, Paterni, Marco, Daros, Clarissa Borguezan, Simova, Iana, Josã© Luis, De Castro E. Silva Pretto, Scali, Maria Chiara, Gaibazzi, Nicola, Severino, Sergio, Djordjevic dikic, Ana, Kasprzak, Jaroslaw D., Zagatina, Angela, Varga, Albert, Lowenstein, Jorge, Merlo, Pablo Martin, Amor, Miguel, Celutkiene, Jelena, Perez, Julio E., DI SALVO, Giovanni, Galderisi, Maurizio, Mori, Fabio, Costantino, Marco Fabio, Massa, Laura, Dekleva, Milica, Chaves, Daniel Quesada, Trambaiolo, Paolo, Citro, Rodolfo, Colonna, Paolo, Rigo, Fausto, Torres, Marco A. R., Monte, Ine, Stankovic, Ivan, Neskovic, Aleksander, Cortigiani, Lauro, Re, Federica, Dodi, Claudio, D'Andrea, Antonello, Villari, Bruno, Arystan, Ayana, De Nes, Michele, Carpeggiani, Clara, de Castro e Silva Pretto, José Lui, Djordjevic-Dikic, Ana, and Di Salvo, Giovanni
- Subjects
Quality Control ,medicine.medical_specialty ,Certification ,Internationality ,media_common.quotation_subject ,Control (management) ,Coronary Disease ,Quality control ,Stress echocardiography ,Wall motion ,Cardiologists ,Clinical Competence ,Echocardiography, Stress ,Humans ,Reproducibility of Results ,Audit ,030204 cardiovascular system & hematology ,Stress ,Credentialing ,Session (web analytics) ,03 medical and health sciences ,0302 clinical medicine ,Reading (process) ,medicine ,Quality (business) ,Medical physics ,030212 general & internal medicine ,Set (psychology) ,media_common ,business.industry ,Cardiology and Cardiovascular Medicine ,Gold standard ,Echocardiography ,Radiology ,business - Abstract
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 videoclips 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. (C) 2017 Elsevier B.V. All rights reserved.
- Published
- 2017