Identifying Factors that Influence Pediatric Echo Lab Image Quality: Development and Validation of a New Assessment...

Area of Science:

• Pediatric cardiology
• Medical imaging analysis
• Quality improvement in healthcare

Background:

• No validated method exists for evaluating transthoracic echocardiogram (TTE) image quality (IQ).
• Structural elements within echocardiogram laboratories that influence TTE IQ remain unidentified.

Purpose of the Study:

• To develop and validate a TTE IQ grading tool for pediatric studies.
• To identify patient and echocardiogram laboratory factors associated with TTE IQ.

Main Methods:

• Ten pediatric echo labs submitted 50 TTEs each; 3 sonographers rated IQ and performed measurements.
• IQ scoring utilized the American College of Cardiology Quality Network (ACC QNet) tool with a novel Likert scale component.
• Validation involved correlating scores with measurement completion and inter-sonographer variability.

Main Results:

• The novel IQ score, ACC QNet, and Likert component correlated with the number of measurements made (p < 0.001).
• The Likert scale component was associated with reduced measurement variability (OR 0.9, p=0.037).
• Worse IQ was linked to higher patient weight, traveling sonographers, lower TTE volume, less dedicated sonographer time, and full-day physician reading sessions.

Conclusions:

• A novel, validated IQ scoring tool for pediatric TTE was developed.
• Modifiable echocardiogram laboratory factors influencing TTE IQ were identified.
• This tool can guide TTE IQ assessment beyond current standards like ACC QNet.