| Authors |
Scali, Maria Chiara ; Ciampi, Quirino ; Picano, Eugenio ; Bossone, Eduardo ; Ferrara, Francesco ; Citro, Rodolfo ; Colonna, Paolo ; Costantino, Marco Fabio ; Cortigiani, Lauro ; D'Andrea, Antonello ; Severino, Sergio ; Dodi, Claudio ; Gaibazzi, Nicola ; Galderisi, Maurizio ; Barbieri, Andrea ; Monte, Ines ; Mori, Fabio ; Reisenhofer, Barbara ; Re, Federica ; Rigo, Fausto ; Trambaiolo, Paolo ; Amor, Miguel ; Lowenstein, Jorge ; Martin Merlo, Pablo ; Daros, Clarissa Borguezan ; de Castro e Silva Pretto, Jose Luis ; Miglioranza, Marcelo Haertel ; Torres, Marco A. R ; de Azevedo Bellagamba, Clarissa Carmona ; Chaves, Daniel Quesada ; Simova, Iana ; Varga, Albert ; Čelutkienė, Jelena ; Kasprzak, Jaroslaw D ; Wierzbowska-Drabik, Karina ; Lipiec, Piotr ; Weiner-Mik, Paulina ; Szymczyk, Eva ; Wdowiak-Okrojek, Katarzyna ; Djordjevic-Dikic, Ana ; Dekleva, Milica ; Stankovic, Ivan ; Neskovic, Aleksandar N ; Zagatina, Angela ; Di Salvo, Giovanni ; Perez, Julio E ; Camarozano, Ana Cristina ; Corciu, Anca Irina ; Boshchenko, Alla ; Lattanzi, Fabio ; Cotrim, Carlos ; Fazendas, Paula ; Haberka, Maciej ; Sobkowic, Bozena ; Kosmala, Wojciech ; Witkowski, Tomasz ; Gosciniak, Piotr ; Salustri, Alessandro ; Rodriguez-Zanella, Hugo ; Leal, Luis Ignacio Martin ; Nikolic, Alexandra ; Gligorova, Suzana ; Urluescu, Madalina-Loredana ; Fiorino, Maria ; Novo, Giuseppina ; Preradovic-Kovacevic, Tamara ; Ostojic, Miodrag ; Beleslin, Branko ; Villari, Bruno ; De Nes, Michele ; Paterni, Marco ; Carpeggiani, Clara |
| Abstract [eng] |
Background: The effectiveness trial \"Stress echo (SE) 2020\" evaluates novel applications of SE in and beyond coronary artery disease. The core protocol also includes 4-site simplified scan of B-lines by lung ultrasound, useful to assess pulmonary congestion. Purpose: To provide web-based upstream quality control and harmonization of B-lines reading criteria. Methods: 60 readers (all previously accredited for regional wall motion, 53 B-lines naive) from 52 centers of 16 countries of SE 2020 network read a set of 20 lung ultrasound video-clips selected by the Pisa lab serving as reference standard, after taking an obligatory web-based learning 2-h module (httpi/se2020.altervista.org). Each test clip was scored for B-lines from 0 (black lung, A-lines, no B-lines) to 10 (white lung, coalescing B-lines). The diagnostic gold standard was the concordant assessment of two experienced readers of the Pisa lab. The answer of the reader was considered correct if concordant with reference standard reading +/- 1 (for instance, reference standard reading of 5 B-lines; correct answer 4, 5, or 6). The a priori determined pass threshold was 18/20 (>= 90%) with R value (intra-class correlation coefficient) between reference standard and recruiting center) > 0.90. Inter-observer agreement was assessed with intra-class correlation coefficient statistics. Results: All 60 readers were successfully accredited: 26 (43%) on first 24 (40%) on second, and 10 (17%) on third attempt. The average diagnostic accuracy of the 60 accredited readers was 95%, with R value of 0.95 compared to reference standard reading. The 53 B-lines naive scored similarly to the 7 B-lines expert on first attempt (90 versus 95%, p = NS). Compared to the step-1 of quality control for regional wall motion abnormalities, the mean reading time per attempt was shorter (17 +/- 3 vs 29 +/- 12 min, p < .01), the first attempt success rate was higher (43 vs 28%, p < 0.01), and the drop-out of readers smaller (0 vs 28%, p < .01). Conclusions: Web-based learning is highly effective for teaching and harmonizing B-lines reading. Echocardiographers without previous experience with B-lines learn quickly. |
