经验对视觉和辛普森双平面回声心脏成像对左心室喷射小部分的评估的影响
S Akil1, J Castaings1,2, P Thind2
1Division of Laboratory Medicine, Department of Clinical Physiology, Karolinska Institute, Huddinge, Sweden.
Clinical physiology and functional imaging
|December 2, 2024
概括
医疗保健专业人员的经验水平显著影响使用心声学测试的左心室喷射率 (LVEF) 评估. 初学者表现出最多的变化,突出了对第二意见的需求,即使是经验丰富的评估者.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 通过心声学对左心室喷射率 (LVEF) 的临床常规评估涉及具有不同经验水平的专业人员.
- 评估人员的专业知识可能会影响LVEF评估的准确性.
研究的目的:
- 通过视觉和辛普森双平面方法,研究评估者经验对LVEF评估的影响.
- 根据经验水平 (初学者,中级,专家) 确定LVEF测量的变化程度.
主要方法:
- 六位具有不同经验水平的评价者通过2D跨胸心回声学 (TTE) 评估了140名患者的LVEF,使用视觉和辛普森双平面方法.
- 评估人员对彼此的结果是盲目的.
- 使用Bland-Altman分析来评估LVEF测量之间的一致性.
主要成果:
- 在LVEF评估中的一致性在专家中最高,在初学者中最低,无论采用何种方法 (视觉或辛普森双平面).
- 在经验组内和经验组之间注意到了变化,显著的p值表明了差异.
- 专家LVEF评估与中级和初级组的评估之间的一致性显示出相当大的偏差和标准偏差.
结论:
- 评估者经验显著影响2D-TTE的视觉和辛普森双平面LVEF评估.
- 在初学者评估者中观察到LVEF测量的更高变化.
- 建议对减少的LVEF评估进行第二次意见,即使对中级和专家评估者也是如此.
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