Cardiovascular Ultrasound (Sep 2018)
Quality control of B-lines analysis in stress Echo 2020
- 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)
Affiliations
- Maria Chiara Scali
- Cardiology Department, Nottola Hospital
- Quirino Ciampi
- CNR, Institute of Clinical Physiology, Biomedicine Department
- Eugenio Picano
- CNR, Institute of Clinical Physiology, Biomedicine Department
- Eduardo Bossone
- Cardiology Department, Ospedale santa Maria Incoronata dell’Olmo
- Francesco Ferrara
- Cardiology Department, Ospedale santa Maria Incoronata dell’Olmo
- Rodolfo Citro
- Cardiology Department and Echocardiography Lab, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”
- Paolo Colonna
- Cardiology Hospital, Policlinico of Bari
- Marco Fabio Costantino
- Cardiology Department, San Carlo Hospital
- Lauro Cortigiani
- Cardiology Department, San Luca Hospital
- Antonello D’. Andrea
- Cardiology Department, Echocardiography Lab, Monaldi Hospital, Second University of Naples
- Sergio Severino
- Cardiology Department, Echocardiography Lab, Monaldi Hospital, Second University of Naples
- Claudio Dodi
- Casa di Cura Figlie di San Camillo
- Nicola Gaibazzi
- Cardiology Department, Parma University Hospital
- Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital
- Andrea Barbieri
- Cardiology Department, Modena University Hospital
- Ines Monte
- Cardio-Thorax-Vascular Department, Echocardiography lab, Policlinico Vittorio Emanuele, University of Catania
- Fabio Mori
- Cardiology Department, Careggi Hospital
- Barbara Reisenhofer
- Cardiology Division, Pontedera-Volterra Hospital
- Federica Re
- Cardiology Department, San Camillo-Forlanini Hospital
- Fausto Rigo
- Cardiology Department, Ospedale dell’Angelo Mestre-Venice
- Paolo Trambaiolo
- Department of Cardiology, Sandro Pertini Hospital
- Miguel Amor
- Cardiology Department, Ramos Mejia Hospital
- Jorge Lowenstein
- Cardiodiagnosticos, Investigaciones Medicas
- Pablo Martin Merlo
- Cardiodiagnosticos, Investigaciones Medicas
- Clarissa Borguezan Daros
- Cardiology Division, Hospital San José
- José Luis de Castro e Silva Pretto
- Hospital Sao Vicente de Paulo e Hospital de Cidade
- Marcelo Haertel Miglioranza
- Cardiology Institute of Rio Grande do Sul
- Marco A. R. Torres
- Hospital de Clinicas de Porto Alegre - Universidade Federal do Rio Grande do Sul
- Clarissa Carmona de Azevedo Bellagamba
- Hospital de Clinicas de Porto Alegre - Universidade Federal do Rio Grande do Sul
- Daniel Quesada Chaves
- Hospital San Vicente de Paul
- Iana Simova
- Acibadem City Clinic Cardiovascular Center, University Hospital
- Albert Varga
- Institute of Family Medicine, University of Szeged
- Jelena Čelutkienė
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Faculty of Medicine, Vilnius University, State Research Institute for Innovative Medicine
- Jaroslaw D. Kasprzak
- Chair of Cardiology, Bieganski Hospital, Medical University
- Karina Wierzbowska-Drabik
- Chair of Cardiology, Bieganski Hospital, Medical University
- Piotr Lipiec
- Chair of Cardiology, Bieganski Hospital, Medical University
- Paulina Weiner-Mik
- Chair of Cardiology, Bieganski Hospital, Medical University
- Eva Szymczyk
- Chair of Cardiology, Bieganski Hospital, Medical University
- Katarzyna Wdowiak-Okrojek
- Chair of Cardiology, Bieganski Hospital, Medical University
- Ana Djordjevic-Dikic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade
- Milica Dekleva
- Clinical Hospital Zvezdara Belgrade
- Ivan Stankovic
- Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade
- Aleksandar N. Neskovic
- Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade
- Angela Zagatina
- Cardiology Department, University Hospital
- Giovanni Di Salvo
- Pediatric Cardiology Department, Brompton Hospital
- Julio E. Perez
- Washington University School of Medicine, Barnes-Jewish Hospital
- Ana Cristina Camarozano
- Hospital de Clinicas UFPR, Medicine Department, Federal University of Paranà
- Anca Irina Corciu
- Department of Cardiology, IRCCS Policlinico San Donato Clinic
- Alla Boshchenko
- Cardiology Research Institute, Tomsk National Research Medical Center of Russian Academy of Sciences
- Fabio Lattanzi
- Cardiothoracic Department, University of Pisa
- Carlos Cotrim
- Heart Center, Hospital da Cruz Vermelha, Lisbon and Medical School of University of Algarve
- Paula Fazendas
- Cardiology Department, Hospital Garcia de Orta
- Maciej Haberka
- Department of Cardiology, School of Health Sciences, Medical University of Silesia
- Bozena Sobkowic
- Department of Cardiology, Medical University of Białystok
- Wojciech Kosmala
- Department of Cardiology, Wroclaw Medical University
- Tomasz Witkowski
- Department of Cardiology, Wroclaw Medical University
- Piotr Gosciniak
- Department of Cardiology, Provincial Hospital
- Alessandro Salustri
- Hamad Medical Corporation, Heart Hospital
- Hugo Rodriguez-Zanella
- Instituto Nacional de Cardiologia Ignacio Chavez
- Luis Ignacio Martin Leal
- Cardiothoracic Department, University of Pisa
- Alexandra Nikolic
- Institute for Cardiovascular Diseases
- Suzana Gligorova
- Cardiology Division Ospedale Casilino
- Madalina-Loredana Urluescu
- Cardiology Department, County Hospital Sibiu, Invasive and Non-Invasive Center for Cardiac and Vascular Pathology in Adults - CVASIC Sibiu, Faculty of Medicine
- Maria Fiorino
- Cardiology Division Ospedale Civico Di Cristina Benfratelli
- Giuseppina Novo
- Cardiology Division, University Hospital
- Tamara Preradovic-Kovacevic
- University Clinical Center
- Miodrag Ostojic
- Institute for Cardiovascular Diseases
- Branko Beleslin
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade
- Bruno Villari
- Cardiology Division, Fatebenefratelli Hospital
- Michele De Nes
- CNR, Institute of Clinical Physiology, Biomedicine Department
- Marco Paterni
- CNR, Institute of Clinical Physiology, Biomedicine Department
- Clara Carpeggiani
- CNR, Institute of Clinical Physiology, Biomedicine Department
- on behalf of Stress Echo 2020 study group of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI)
- DOI
- https://doi.org/10.1186/s12947-018-0138-7
- Journal volume & issue
-
Vol. 16,
no. 1
pp. 1 – 9
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 < .01), the first attempt success rate was higher (43 vs 28%, p < 0.01), and the drop-out of readers smaller (0 vs 28%, p < .01). Conclusions Web-based learning is highly effective for teaching and harmonizing B-lines reading. Echocardiographers without previous experience with B-lines learn quickly.
Keywords
