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Updated: Jun 30, 2026

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
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Multidisciplinary Content Validation of the GiriMok Point-of-Care Protocol for Neonatal Cyanotic Congenital Heart

Girish Gupta1, Syed Moiz Ahmed1, Richa Joshi2

  • 1Neonatology, Graphic Era Institute of Medical Sciences, Dehradun, IND.

Cureus
|June 29, 2026
PubMed

Insights

The GiriMok Protocol, a new point-of-care tool for neonatal cyanotic congenital heart disease, achieved unanimous expert validation. This validated protocol is ready for clinical evaluation as a critical decision-support tool.

Area of Science:

  • Neonatology
  • Pediatric Cardiology
  • Emergency Medicine

Background:

  • Neonatal cyanotic congenital heart disease presents a time-critical emergency.
  • Existing guidelines lack a validated point-of-care (POC) protocol for frontline clinicians.
  • The GiriMok Protocol was developed to address this critical need in diverse clinical settings.

Purpose of the Study:

  • To develop and establish the content validity of the GiriMok POC Protocol.
  • To ensure the protocol is suitable for immediate bedside decision-making by frontline clinicians.
  • To create a rigorous, expert-validated decision-support tool for neonatal emergencies.

Main Methods:

  • A four-phase iterative, multidisciplinary expert validation process was employed.
  • Phase 1 involved 18 experts assessing 33 parameters; Phase 2 involved 5 specialists revalidating a 16-item instrument.
  • Content Validity Index (CVI) and modified kappa (k*) were used to measure validity, with subsequent guideline-based enhancements.

Main Results:

  • Phase 1 yielded a Scale-CVI/Ave of 0.927, with all items meeting validity thresholds and no safety concerns.
  • Phase 2 achieved perfect scores (S-CVI/Ave = k* = 1.000) after integrating expert feedback and revisions.
  • 35 expert-informed corrections led to the final GiriMok V4.0, demonstrating unanimous multidisciplinary validation.

Conclusions:

  • The GiriMok POC Protocol successfully achieved unanimous multidisciplinary content validation.
  • The perfect Phase 2 CVI underscores the protocol's methodological rigor and responsiveness to expert input.
  • The validated GiriMok Protocol is poised for prospective clinical evaluation and national dissemination as a neonatal emergency decision-support tool.

Keywords:
clinical decision supportcontent validitycontent validity indexechocardiographyiterative validationneonatal cyanotic congenital heart diseasepoint-of-care protocolprostaglandin e₁pulse oximetry

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