Echocardiographic agreement in the diagnostic evaluation for infective endocarditis

Trine Kiilerich Lauridsen, Christine Selton-Suty, Steven Tong, Luis Afonso, Enrico Cecchi, Lawrence Park, Eric Yow, Huiman X. Barnhart, Carlos Paré, Zainab Samad, Donald Levine, Gail Peterson, Amy Butler Stancoven, Magnus Carl Johansson, Stuart Dickerman, Syahidah Tamin, Gilbert Habib, Pamela S. Douglas, Niels Eske Bruun, Anna Lisa Crowley

Research output: Contribution to journalArticle

Abstract

Echocardiography is essential for the diagnosis and management of infective endocarditis (IE). However, the reproducibility for the echocardiographic assessment of variables relevant to IE is unknown. Objectives of this study were: (1) To define the reproducibility for IE echocardiographic variables and (2) to describe a methodology for assessing quality in an observational cohort containing site-interpreted data. IE reproducibility was assessed on a subset of echocardiograms from subjects enrolled in the International Collaboration on Endocarditis registry. Specific echocardiographic case report forms were used. Intra-observer agreement was assessed from six site readers on ten randomly selected echocardiograms. Inter-observer agreement between sites and an echocardiography core laboratory was assessed on a separate random sample of 110 echocardiograms. Agreement was determined using intraclass correlation (ICC), coverage probability (CP), and limits of agreement for continuous variables and kappa statistics (κweighted) and CP for categorical variables. Intra-observer agreement for LVEF was excellent [ICC = 0.93 ± 0.1 and all pairwise differences for LVEF (CP) were within 10 %]. For IE categorical echocardiographic variables, intra-observer agreement was best for aortic abscess (κweighted = 1.0, CP = 1.0 for all readers). Highest inter-observer agreement for IE categorical echocardiographic variables was obtained for vegetation location (κweighted = 0.95; 95 % CI 0.92–0.99) and lowest agreement was found for vegetation mobility (κweighted = 0.69; 95 % CI 0.62–0.86). Moderate to excellent intra- and inter-observer agreement is observed for echocardiographic variables in the diagnostic assessment of IE. A pragmatic approach for determining echocardiographic data reproducibility in a large, multicentre, site interpreted observational cohort is feasible.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalInternational Journal of Cardiovascular Imaging
DOIs
StateAccepted/In press - Apr 21 2016

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Endocarditis
Echocardiography
Abscess
Registries

Keywords

  • Echocardiographic agreement
  • Echocardiography core laboratory
  • Infective endocarditis
  • Reproducibility

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Lauridsen, T. K., Selton-Suty, C., Tong, S., Afonso, L., Cecchi, E., Park, L., ... Crowley, A. L. (Accepted/In press). Echocardiographic agreement in the diagnostic evaluation for infective endocarditis. International Journal of Cardiovascular Imaging, 1-11. https://doi.org/10.1007/s10554-016-0873-5

Echocardiographic agreement in the diagnostic evaluation for infective endocarditis. / Lauridsen, Trine Kiilerich; Selton-Suty, Christine; Tong, Steven; Afonso, Luis; Cecchi, Enrico; Park, Lawrence; Yow, Eric; Barnhart, Huiman X.; Paré, Carlos; Samad, Zainab; Levine, Donald; Peterson, Gail; Stancoven, Amy Butler; Johansson, Magnus Carl; Dickerman, Stuart; Tamin, Syahidah; Habib, Gilbert; Douglas, Pamela S.; Bruun, Niels Eske; Crowley, Anna Lisa.

In: International Journal of Cardiovascular Imaging, 21.04.2016, p. 1-11.

Research output: Contribution to journalArticle

Lauridsen, TK, Selton-Suty, C, Tong, S, Afonso, L, Cecchi, E, Park, L, Yow, E, Barnhart, HX, Paré, C, Samad, Z, Levine, D, Peterson, G, Stancoven, AB, Johansson, MC, Dickerman, S, Tamin, S, Habib, G, Douglas, PS, Bruun, NE & Crowley, AL 2016, 'Echocardiographic agreement in the diagnostic evaluation for infective endocarditis', International Journal of Cardiovascular Imaging, pp. 1-11. https://doi.org/10.1007/s10554-016-0873-5
Lauridsen, Trine Kiilerich ; Selton-Suty, Christine ; Tong, Steven ; Afonso, Luis ; Cecchi, Enrico ; Park, Lawrence ; Yow, Eric ; Barnhart, Huiman X. ; Paré, Carlos ; Samad, Zainab ; Levine, Donald ; Peterson, Gail ; Stancoven, Amy Butler ; Johansson, Magnus Carl ; Dickerman, Stuart ; Tamin, Syahidah ; Habib, Gilbert ; Douglas, Pamela S. ; Bruun, Niels Eske ; Crowley, Anna Lisa. / Echocardiographic agreement in the diagnostic evaluation for infective endocarditis. In: International Journal of Cardiovascular Imaging. 2016 ; pp. 1-11.
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abstract = "Echocardiography is essential for the diagnosis and management of infective endocarditis (IE). However, the reproducibility for the echocardiographic assessment of variables relevant to IE is unknown. Objectives of this study were: (1) To define the reproducibility for IE echocardiographic variables and (2) to describe a methodology for assessing quality in an observational cohort containing site-interpreted data. IE reproducibility was assessed on a subset of echocardiograms from subjects enrolled in the International Collaboration on Endocarditis registry. Specific echocardiographic case report forms were used. Intra-observer agreement was assessed from six site readers on ten randomly selected echocardiograms. Inter-observer agreement between sites and an echocardiography core laboratory was assessed on a separate random sample of 110 echocardiograms. Agreement was determined using intraclass correlation (ICC), coverage probability (CP), and limits of agreement for continuous variables and kappa statistics (κweighted) and CP for categorical variables. Intra-observer agreement for LVEF was excellent [ICC = 0.93 ± 0.1 and all pairwise differences for LVEF (CP) were within 10 {\%}]. For IE categorical echocardiographic variables, intra-observer agreement was best for aortic abscess (κweighted = 1.0, CP = 1.0 for all readers). Highest inter-observer agreement for IE categorical echocardiographic variables was obtained for vegetation location (κweighted = 0.95; 95 {\%} CI 0.92–0.99) and lowest agreement was found for vegetation mobility (κweighted = 0.69; 95 {\%} CI 0.62–0.86). Moderate to excellent intra- and inter-observer agreement is observed for echocardiographic variables in the diagnostic assessment of IE. A pragmatic approach for determining echocardiographic data reproducibility in a large, multicentre, site interpreted observational cohort is feasible.",
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