TY - JOUR

T1 - Quality control of regional wall motion analysis in stress Echo 2020

AU - 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

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

VL - 249

SP - 479

EP - 485

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -