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On-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists

BACKGROUND: Transthoracic echocardiograms (TTE) performed and interpreted by cardiology fellows during off-duty hours are critical to patient care, however limited data exist on their interpretive accuracy. Our aims were to determine the discordance rate between TTEs performed and interpreted by car...

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Autores principales: Spahillari, Aferdita, McCormick, Ian, Yang, Jesse X., Quinn, Gene R., Manning, Warren J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567532/
https://www.ncbi.nlm.nih.gov/pubmed/31200721
http://dx.doi.org/10.1186/s12909-019-1634-7
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author Spahillari, Aferdita
McCormick, Ian
Yang, Jesse X.
Quinn, Gene R.
Manning, Warren J.
author_facet Spahillari, Aferdita
McCormick, Ian
Yang, Jesse X.
Quinn, Gene R.
Manning, Warren J.
author_sort Spahillari, Aferdita
collection PubMed
description BACKGROUND: Transthoracic echocardiograms (TTE) performed and interpreted by cardiology fellows during off-duty hours are critical to patient care, however limited data exist on their interpretive accuracy. Our aims were to determine the discordance rate between TTEs performed and interpreted by cardiology fellows and National Board of Echocardiography certified attending cardiologists and to identify factors associated with discordance. METHODS: Consecutive on-call TTEs acquired and interpreted by 1st year cardiology fellows over 4.6 years at an academic center were prospectively evaluated by attending cardiologists. Fellow interpretations were classified as concordant or discordant with the attending interpretation. We assessed the association of patient, imaging and fellow characteristics with discordance. RESULTS: A total of 777 TTE interpretations (730 patients) were performed/interpreted by 40 first year fellows and overread by 13 attendings. The most common indications were assessment of left ventricular function (40.9%) and pericardial effusion (37.3%). There was a major or minor discordance in 4.1 and 17.4% of studies, respectively with 42.1% of disagreements occurring in assessment of left ventricular size and function. The indication to assess left ventricular function [OR 2.19, 95% CI (1.32, 3.62), P = 0.002 vs. pericardial effusion] and greater duration of echocardiographic image acquisition (OR 1.02, 95% CI 1.01, 1.03, P = 0.004) were independently associated with overall discordance. CONCLUSIONS: In this large prospective study we found that attending cardiologists disagreed with 1 in 5 fellow TTE interpretations. Standardized tools for evaluation of echocardiograms performed by fellows are needed to ensure quality of training and patient safety. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12909-019-1634-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-65675322019-06-17 On-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists Spahillari, Aferdita McCormick, Ian Yang, Jesse X. Quinn, Gene R. Manning, Warren J. BMC Med Educ Research Article BACKGROUND: Transthoracic echocardiograms (TTE) performed and interpreted by cardiology fellows during off-duty hours are critical to patient care, however limited data exist on their interpretive accuracy. Our aims were to determine the discordance rate between TTEs performed and interpreted by cardiology fellows and National Board of Echocardiography certified attending cardiologists and to identify factors associated with discordance. METHODS: Consecutive on-call TTEs acquired and interpreted by 1st year cardiology fellows over 4.6 years at an academic center were prospectively evaluated by attending cardiologists. Fellow interpretations were classified as concordant or discordant with the attending interpretation. We assessed the association of patient, imaging and fellow characteristics with discordance. RESULTS: A total of 777 TTE interpretations (730 patients) were performed/interpreted by 40 first year fellows and overread by 13 attendings. The most common indications were assessment of left ventricular function (40.9%) and pericardial effusion (37.3%). There was a major or minor discordance in 4.1 and 17.4% of studies, respectively with 42.1% of disagreements occurring in assessment of left ventricular size and function. The indication to assess left ventricular function [OR 2.19, 95% CI (1.32, 3.62), P = 0.002 vs. pericardial effusion] and greater duration of echocardiographic image acquisition (OR 1.02, 95% CI 1.01, 1.03, P = 0.004) were independently associated with overall discordance. CONCLUSIONS: In this large prospective study we found that attending cardiologists disagreed with 1 in 5 fellow TTE interpretations. Standardized tools for evaluation of echocardiograms performed by fellows are needed to ensure quality of training and patient safety. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12909-019-1634-7) contains supplementary material, which is available to authorized users. BioMed Central 2019-06-14 /pmc/articles/PMC6567532/ /pubmed/31200721 http://dx.doi.org/10.1186/s12909-019-1634-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Spahillari, Aferdita
McCormick, Ian
Yang, Jesse X.
Quinn, Gene R.
Manning, Warren J.
On-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists
title On-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists
title_full On-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists
title_fullStr On-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists
title_full_unstemmed On-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists
title_short On-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists
title_sort on-call transthoracic echocardiographic interpretation by first year cardiology fellows: comparison with attending cardiologists
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567532/
https://www.ncbi.nlm.nih.gov/pubmed/31200721
http://dx.doi.org/10.1186/s12909-019-1634-7
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