PMID- 30870460
OWN - NLM
STAT- MEDLINE
DCOM- 20191202
LR  - 20200309
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 14
IP  - 3
DP  - 2019
TI  - Reproducibility of sublingual microcirculation parameters obtained from 
      sidestream darkfield imaging.
PG  - e0213175
LID - 10.1371/journal.pone.0213175 [doi]
LID - e0213175
AB  - BACKGROUND: Changes in the microcirculation may be used as a surrogate outcome in 
      studies on cardiovascular disease. We assessed the reliability characteristics of 
      the sublingual microcirculation parameters Vascular Density (VD), Red Blood Cell 
      Filling (RBCF), and Perfused Boundary Region (PBR) as obtained by sidestream 
      darkfield imaging. METHODS: For each of the three parameters, the variance 
      components of measurement, the Intraclass Correlation Coefficient (ICC), the 
      Standard Error of Measurement, and the limits of agreement were estimated for the 
      intra-rater setting (N = 50) and the inter-rater setting (N = 48). Subsequently, 
      as a proof of concept, the reliability measures were used for a power analysis to 
      design studies to evaluate the effect of acute stimuli-i.e. having a meal (N = 
      50) and cigarette smoking (N = 21) on the three parameters. RESULTS: 
      Reproducibility was poor for all three parameters. The intra-rater ICC for 2 
      measurements was 0.28 (95% CI: 0.04, 0.53) for the VD, 0.51 (95% CI: 0.27, 0.69) 
      for the RBCF, and 0.33 (95% CI: 0.08-0.56) for the PBR. The standard errors of 
      measurement and the limits of agreement for all three parameters were larger than 
      most statistically significant intra-individual or inter-individual differences 
      reported in previous studies. The proofs of concept showed that sample sizes in 
      excess of 600 subjects are necessary to reach statistical significance for the 
      observed effects of having a meal or smoking on VD and PBR. CONCLUSIONS: The 
      reliability of the three sublingual microcirculation parameters in their current 
      form appears to be low and a large sample size is advisable for their use in 
      conditions similar to those we describe.
FAU - Valerio, Luca
AU  - Valerio L
AUID- ORCID: 0000-0003-4466-0724
AD  - Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, 
      Netherlands.
AD  - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, 
      Netherlands.
FAU - Peters, Ron J
AU  - Peters RJ
AD  - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, 
      Netherlands.
FAU - Zwinderman, Aeilko H
AU  - Zwinderman AH
AD  - Department of Clinical Epidemiology and Biostatistics, Amsterdam UMC, University 
      of Amsterdam, Amsterdam, Netherlands.
FAU - Pinto-Sietsma, Sara-Joan
AU  - Pinto-Sietsma SJ
AD  - Department of Clinical Epidemiology and Biostatistics, Amsterdam UMC, University 
      of Amsterdam, Amsterdam, Netherlands.
AD  - Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, 
      Amsterdam, Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190314
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Cardiovascular Diseases/pathology
MH  - Erythrocytes/physiology
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Microcirculation/*physiology
MH  - Middle Aged
MH  - Mouth Floor/*blood supply
MH  - Reproducibility of Results
MH  - Video Recording/*methods
PMC - PMC6417651
COIS- The authors have declared that no competing interests exist.
EDAT- 2019/03/15 06:00
MHDA- 2019/12/04 06:00
PMCR- 2019/03/14
CRDT- 2019/03/15 06:00
PHST- 2018/08/12 00:00 [received]
PHST- 2019/02/15 00:00 [accepted]
PHST- 2019/03/15 06:00 [entrez]
PHST- 2019/03/15 06:00 [pubmed]
PHST- 2019/12/04 06:00 [medline]
PHST- 2019/03/14 00:00 [pmc-release]
AID - PONE-D-18-23760 [pii]
AID - 10.1371/journal.pone.0213175 [doi]
PST - epublish
SO  - PLoS One. 2019 Mar 14;14(3):e0213175. doi: 10.1371/journal.pone.0213175. 
      eCollection 2019.