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Practice Variations in Pediatric Echocardiography Laboratories.

Joseph A Camarda1, Angira Patel2, Michael R Carr2

  • 1Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E Chicago Avenue, Box 21, Chicago, IL, 60611-2991, USA. jcamarda@luriechildrens.org.

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Pediatric echocardiogram labs show significant practice variations in performance and analysis, despite 2010 quantification guidelines. Further consensus is needed to standardize pediatric echocardiogram interpretation and improve patient care.

Keywords:
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Area of Science:

  • Pediatric Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Quantification guidelines for pediatric echocardiograms were established in 2010.
  • A standardized protocol for performance and analysis was not defined, leading to potential practice variations.

Purpose of the Study:

  • To identify and assess practice variations in pediatric echocardiogram performance and analysis among North American laboratories.

Main Methods:

  • A survey was distributed to 85 North American pediatric echocardiogram laboratory directors.
  • The survey comprised 29 questions covering demographics, image acquisition, parameters evaluated, and methods for assessing cardiac structures and function.

Main Results:

  • Fifty-five percent of laboratories responded, predominantly academic and urban centers.
  • Significant variations were observed in image acquisition methods, color scale settings, and assessment of left ventricular function (M-mode shortening fraction, qualitative, Doppler Tissue Imaging).
  • Qualitative assessment is the most common method for right ventricular function and valve assessment, while left ventricular mass is widely measured with varied calculation techniques.

Conclusions:

  • Despite existing quantification guidelines, substantial non-uniformity persists in pediatric echocardiogram performance and analysis.
  • Further research is necessary to understand the reasons for these variations and to develop consensus guidelines for improved interpretation, consistency, and patient care.