Journal of the American Society of Echocardiography
Clinical InvestigationLeft Ventricular Mechanics and FunctionImproved Interobserver Variability and Accuracy of Echocardiographic Visual Left Ventricular Ejection Fraction Assessment through a Self-Directed Learning Program Using Cardiac Magnetic Resonance Images
Section snippets
Baseline Assessment
Thirty two-dimensional transthoracic echocardiograms with (n = 8) and without (n = 22) contrast administration for left ventricular (LV) opacification were chosen on the basis of the availability of a CMR study with appropriate images for LVEF measurement within 48 hours of echocardiography and without any intervening procedures or changes in clinical status. Selected clips (consisting of three apical views as well as basal, mid, and apical short-axis views as available, displayed with equal
Cases and Participants
Among the 31 participants 11 were sonographers and 20 were physicians. The median duration of experience among the sonographers was 3.5 years (interquartile range, 24.3 years; range, 1–32 years), while among the physicians, it was 9.5 years (interquartile range, 19.5 years; range, 1–36 years). All sonographers were full-time clinical staff members who perform on average 8–10 echocardiographic studies per day and provide complete preliminary reports, including LVEF estimation. The physicians
Discussion
Continuous quality improvement is an essential component of an echocardiography laboratory. However, quality control programs can be organizationally challenging.8 This study illustrates the use of a self-directed program to improve the IOV and accuracy of visual EF estimation among a group of sonographers and cardiologists, with the suggestion that those with lower baseline accuracy are the greatest beneficiaries. In addition, we found that the use of combined physician-sonographer EF
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