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Exercise Oscillatory Ventilation: Interreviewer Agreement and a Novel Determination
Clinton A Brawner1, Jonathan K Ehrman1, Jonathan Myers1
1Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI.
Medicine and Science in Sports and Exercise
|September 14, 2017
Summary
Interreviewer agreement for exercise oscillatory ventilation (EOV) in heart failure (HF) patients is fair to moderate. A new objective measure, ventilation dispersion index (VDI), shows strong predictive validity for EOV and prognosis in HF.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Medical Technology
Background:
- Exercise oscillatory ventilation (EOV) determination is subjective, lacking reported interreviewer agreement.
- Accurate EOV assessment is crucial for risk stratification in heart failure (HF) patients.
Purpose of the Study:
- To determine interreviewer agreement for EOV in HF patients.
- To introduce and validate a novel, objective measure for EOV.
Main Methods:
- Secondary analysis of the HEART Camp study involving 243 HF patients.
- Blinded review by six experts to determine EOV, with agreement assessed by Fleiss kappa (κ).
- Calculation and validation of the ventilation dispersion index (VDI) using receiver operator characteristics (ROC) curve analysis.
Main Results:
- Fair interreviewer agreement for EOV using 10-s discrete averages (κ = 0.303) and moderate agreement using 30-s rolling averages (κ = 0.429).
- Prevalence rates of positive/indeterminate EOV varied based on averaging methods.
- VDI demonstrated strong predictive validity for EOV (area under ROC curve: 0.852–0.890).
Conclusions:
- Fair to moderate interreviewer agreement for EOV in HF patients may impact risk stratification.
- The ventilation dispersion index (VDI) is a promising, objective tool for assessing EOV and predicting prognosis in HF.
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