Improving accuracy in diagnosing aortic stenosis severity: An in‐depth analysis of echocardiographic measurement error through literature review and simulation study.
Aims: The present guidelines advise replacing the aortic valve for individuals with severe aortic stenosis (AS) based on various echocardiographic parameters. Accurate measurements are essential to avoid misclassification and unnecessary interventions. The objective of this study was to evaluate the...
| Publicado en: | Echocardiography Vol. 40; no. 9; pp. 892 - 903 |
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| Autores principales: | , , , , , , , |
| Formato: | diagnostic images equations & formulas review tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=171810290&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 171810290 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Sep2023 vid: 40 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 171810290 167615620 171810290 171810290 10.1111/echo.15664 171810290 ppf: 892 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Improving accuracy in diagnosing aortic stenosis severity: An in‐depth analysis of echocardiographic measurement error through literature review and simulation study. aug: au: Velders, Bart J. J. Groenwold, Rolf H. H. Ajmone Marsan, Nina Kappetein, Arie‐Pieter Wijngaarden, Rob A. F. De Lind Van Braun, Jerry Klautz, Robert J. M. Vriesendorp, Michiel D. affil: Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands sug: subj: Aortic Valve Stenosis Diagnosis Validity Echocardiography Methods Measurement Error Simulations Decision Making, Clinical Interrater Reliability Severity of Illness Diagnostic Errors ab: Aims: The present guidelines advise replacing the aortic valve for individuals with severe aortic stenosis (AS) based on various echocardiographic parameters. Accurate measurements are essential to avoid misclassification and unnecessary interventions. The objective of this study was to evaluate the influence of measurement error on the echocardiographic evaluation of the severity of AS. Methods and results: A systematic review was performed to examine whether measurement errors are reported in studies focusing on the prognostic value of peak aortic jet velocity (Vmax), mean pressure gradient (MPG), and effective orifice area (EOA) in asymptomatic patients with AS. Out of the 37 studies reviewed, 17 (46%) acknowledged the existence of measurement errors, but none of them utilized methods to address them. Secondly, the magnitude of potential errors was collected from available literature for use in clinical simulations. Interobserver variability ranged between 0.9% and 8.3% for Vmax and MPG but was higher for EOA (range 7.7%‐12.7%), indicating lower reliability. Assuming a circular left ventricular outflow tract area led to a median underestimation of EOA by 23% compared to planimetry by other modalities. A clinical simulation resulted in the reclassification of 42% of patients, shifting them from a diagnosis of severe AS to moderate AS. Conclusions: Measurement errors are underreported in studies on echocardiographic assessment of AS severity. These errors can lead to misclassification and misdiagnosis. Clinicians and scientists should be aware of the implications for accurate clinical decision‐making and assuring research validity. pubtype: Academic Journal doctype: diagnostic images equations & formulas review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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