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AuthorAlbaroudi, Bilal
AuthorHaddad, Mahmoud
AuthorAlbaroudi, Omar
AuthorAbdel-Rahman, Manar E
AuthorJarman, Robert
AuthorHarris, Tim
Available date2021-08-31T08:09:36Z
Publication Date2021-08-17
Publication NameEuropean Journal of Emergency Medicine
Identifierhttp://dx.doi.org/10.1097/MEJ.0000000000000866
CitationAlbaroudi, Bilala; Haddad, Mahmouda; Albaroudi, Omara; Abdel-Rahman, Manar E.b; Jarman, Robertc,,d; Harris, Tima,,e Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert, European Journal of Emergency Medicine: August 17, 2021 - Volume - Issue - doi: 10.1097/MEJ.0000000000000866
ISSN0969-9546
URIhttp://hdl.handle.net/10576/22314
AbstractAssessing left ventricular systolic function (LVSF) by echocardiography assists in the diagnosis and management of a diverse range of patients presenting to the emergency department (ED). We evaluated the agreement between ED-based clinician sonographers and apriori-defined expert sonographers. We conducted a systematic review and meta-analysis based on Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. We searched Medline, Excerpta Medica dataBASE, Cochrane, ClinicalTrials.gov, Turning Research Into Practice and Google Scholar for eligible studies from inception to February 2021. Risk of bias was evaluated using Quality Assessment Tool for Diagnostic Accuracy Studies-2 tool. The level of agreement between clinician and expert sonographers was measured using kappa, sensitivity, specificity, positive and negative likelihood ratio statistics using random-effects models. Twelve studies were included (1131 patients, 1229 scans and 159 clinician sonographers). Significant heterogeneity was identified in patient selection, methods of assessment of LVSF, reference standards and statistical methods for assessing agreement. The overall quality of studies was low, with most being small, single centre convenience samples. A meta-analysis including seven studies (786 scans) where visual estimation method was used by clinician sonographers demonstrated simple Kappa of 0.68 [95% confidence interval (CI), 0.57-0.79], and sensitivity, specificity, positive and negative likelihood ratio of 89% (95% CI, 80-94%), 85% (95% CI, 80-89%), 5.98 (95% CI, 4.13-8.68) and 0.13 (95% CI, 0.06-0.24), respectively, between clinician sonographer and expert sonographer for normal/abnormal LVSF. The weighted kappa for five studies (429 scans) was 0.70 (95% CI, 0.61-0.80) for normal/reduced/severely reduced LVSF. There is substantial agreement between ED-based clinician sonographers and expert sonographers for assessing LVSF using visual estimation and ranking it as normal/reduced, or normal/reduced/severely reduced, in patients presenting to ED.
Languageen
PublisherLippincott, Williams & Wilkins
Subjectcardiologists
Subjectechocardiography
Subjectemergency medicine
Subjectleft ventricular dysfunction
Subjectmeta-analysis
Subjectobserver variation
Subjectpoint-of-care systems
Subjectsensitivity and specificity
Subjectsystematic review
TitleAssessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis.
TypeArticle Review
ESSN1473-5695


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