Quality control of regional wall motion analysis in stress Echo 2020.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ciampi Quirino, Picano Eugenio, Paterni Marco, Daros Clarissa Borguezan, Simova Iana, de Castro E Silva Pretto José Luis, 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 Ines, Stankovic Ivan, Neskovic Aleksander, Cortigiani Lauro, Re Federica, Dodi Claudio, D'Andrea Antonello, Villari Bruno, Arystan Ayana, De Nes Michele, Carpeggiani Clara, Stress Echo 2020 study group of the Italian Society of Cardiovascular Echography
Аннотация
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 31years (mean value 18years). 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.