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The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
Intra- and Inter-Rater Agreement between X-Ray Views for Umbilical Catheter Position
Srinivasa Murthy Doreswamy1, Sumesh Thomas2, Sourabh Dutta3
1Department of Pediatrics, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, India.
Objective:
We determined intra- and inter-rater agreement for umbilical arterial/venous catheter (umbilical arterial catheter [UAC] and umbilical venous catheter [UVC], respectively) positions on supine anteroposterior (AP) and horizontal dorsal decubitus (HDD) X-ray views to determine whether two views are routinely required.
Study Design:
This retrospective study was conducted in McMaster University, Canada. Pairs of AP and HDD radiographs were coded and rated in random sequence by two experienced raters. Primary outcome was intra-rater agreement (κ) between AP and HDD views for UVC catheter tip position. Secondary outcomes included inter-rater κ for UVC position; inter- and intra-rater κ for UAC position, inter- and intra-rater κ for follow-up action. To detect κ of 0.8 (width of 95% confidence interval = 0.1), 138 radiograph pairs were required.
Results:
Intra-rater agreement tended to be higher for UVC versus UAC position (Rater#1: κ = 0.44 vs. 0.16, respectively, p = 0.08; and #2: κ = 0.56 vs. 0.47, respectively, p = 0.5). Inter-rater agreement was higher on AP versus HDD view for UVC position (κ = 0.6 vs. 0.29, respectively, p = 0.03) and action recommended for UVC (κ = 0.61 and 0.19, respectively, p < 0.001).
Conclusion:
AP is superior to HDD view for UVC.
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