PMID- 29315095
OWN - NLM
STAT- MEDLINE
DCOM- 20191210
LR  - 20191217
IS  - 1473-5695 (Electronic)
IS  - 0969-9546 (Linking)
VI  - 26
IP  - 3
DP  - 2019 Jun
TI  - Observational study in healthy volunteers to define interobserver reliability of 
      ultrasound haemodynamic monitoring techniques performed by trainee doctors.
PG  - 217-223
LID - 10.1097/MEJ.0000000000000533 [doi]
AB  - OBJECTIVES: Bedside ultrasound is increasingly being used to guide fluid 
      management in shocked patients. Little data exist on the inter-rater reliability 
      of techniques used, especially when performed by nonexpert trainee doctors. The 
      primary aim of this study is to measure the inter-rater reliability of five 
      ultrasound techniques commonly used to guide fluid management: inferior vena cava 
      collapsibility index (IVCCI), transthoracic echocardiography (TTE)-derived stroke 
      volumes, ultrasound cardiac output monitor (USCOM) derived stroke volume and 
      carotid artery blood flow and corrected flow time measurements. METHODS: Two 
      Royal College of Emergency Medicine level one ultrasound-certified emergency 
      medicine trainees performed paired ultrasound measurements on 31 healthy 
      nonpatient volunteers. Inter-rater reliability was assessed through three 
      indices: interclass correlation coefficient (ICC), limits of agreements (LOAs) 
      derived from Band-Altman plots and the proportion of paired scans with absolute 
      differences of less that 15% (defined as agreement). RESULTS: TTE-derived 
      measurements performed the best overall, with an LOA of 22%, an ICC of 0.55 and 
      an agreement of 80%. USCOM also performed well, with an LOA of 33%, an ICC of 
      0.68 and an agreement of 58%. IVCCI and carotid artery-derived measurements 
      performed poorly across all indices. CONCLUSION: TTE-derived measurements showed 
      the highest level of inter-rater reliability and can thus be expected to provide 
      reliable measures over time with different sonographer clinicians. USCOM 
      interobserver reliability was also adequate for clinical use. However, on the 
      basis of inter-reliability measures, IVCCI and carotid artery measurements were 
      found to be inadequate for clinical use.
FAU - Bussmann, Benjamin M
AU  - Bussmann BM
AD  - Emergency Department, Royal London Hospital, Barts Health NHS Trust, London, UK.
FAU - Sharma, Shrey
AU  - Sharma S
FAU - Mcgregor, David
AU  - Mcgregor D
FAU - Hulme, William
AU  - Hulme W
FAU - Harris, Tim
AU  - Harris T
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - England
TA  - Eur J Emerg Med
JT  - European journal of emergency medicine : official journal of the European Society 
      for Emergency Medicine
JID - 9442482
SB  - IM
MH  - Adult
MH  - *Clinical Competence
MH  - Echocardiography/*methods
MH  - Education, Medical, Graduate/*methods
MH  - Female
MH  - Healthy Volunteers
MH  - Hemodynamic Monitoring/*methods
MH  - Hospitals, Teaching/*organization & administration
MH  - Humans
MH  - Male
MH  - Observer Variation
MH  - *Point-of-Care Testing
MH  - Risk Assessment
MH  - Task Performance and Analysis
MH  - United Kingdom
EDAT- 2018/01/10 06:00
MHDA- 2019/12/18 06:00
CRDT- 2018/01/10 06:00
PHST- 2018/01/10 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2018/01/10 06:00 [entrez]
AID - 10.1097/MEJ.0000000000000533 [doi]
PST - ppublish
SO  - Eur J Emerg Med. 2019 Jun;26(3):217-223. doi: 10.1097/MEJ.0000000000000533.