TY - JOUR
T1 - Echocardiographic agreement in the diagnostic evaluation for infective endocarditis
AU - Lauridsen, Trine K.
AU - Selton-Suty, Christine
AU - Tong, Steven
AU - Afonso, Luis
AU - Cecchi, Enrico
AU - Park, Lawrence
AU - Yow, Eric
AU - Barnhart, Huiman X.
AU - Paré, Carlos
AU - Samad, Zainab
AU - Levine, Donald
AU - Peterson, Gail
AU - Stancoven, Amy B.
AU - Johansson, Magnus C.
AU - Dickerman, Stuart
AU - Tamin, Syahidah
AU - Habib, Gilbert
AU - Douglas, Pamela S.
AU - Bruun, Niels E.
AU - Crowley, Anna Lisa
PY - 2016
Y1 - 2016
N2 - 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 (?weighted) 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 (?weighted = 1.0, CP = 1.0 for all readers). Highest inter-observer agreement for IE categorical echocardiographic variables was obtained for vegetation location (?weighted = 0.95; 95 % CI 0.92�0.99) and lowest agreement was found for vegetation mobility (?weighted = 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. � 2016 Springer Science+Business Media Dordrecht
AB - 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 (?weighted) 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 (?weighted = 1.0, CP = 1.0 for all readers). Highest inter-observer agreement for IE categorical echocardiographic variables was obtained for vegetation location (?weighted = 0.95; 95 % CI 0.92�0.99) and lowest agreement was found for vegetation mobility (?weighted = 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. � 2016 Springer Science+Business Media Dordrecht
UR - http://www.scopus.com/inward/record.url?scp=84964389906&partnerID=8YFLogxK
U2 - 10.1007/s10554-016-0873-5
DO - 10.1007/s10554-016-0873-5
M3 - Article
C2 - PubMed:27100526
VL - 32
SP - 1041
EP - 1051
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
SN - 1569-5794
IS - 7
ER -