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Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians

Background: Arterial Doppler Ultrasound waveform (DW) analysis allows the detection and evaluation of lower extremity peripheral artery disease. The high heterogeneity of the reported description of DW is reduced by the use of classification. However, the reliability of these classifications is eith...

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Autores principales: Lanéelle, Damien, Guillaumat, Jérôme, Trihan, Jean-Eudes, Pottier, Camille, Omarjee, Loukman, Mahé, Guillaume
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8185013/
https://www.ncbi.nlm.nih.gov/pubmed/34113660
http://dx.doi.org/10.3389/fcvm.2021.640838
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author Lanéelle, Damien
Guillaumat, Jérôme
Trihan, Jean-Eudes
Pottier, Camille
Omarjee, Loukman
Mahé, Guillaume
author_facet Lanéelle, Damien
Guillaumat, Jérôme
Trihan, Jean-Eudes
Pottier, Camille
Omarjee, Loukman
Mahé, Guillaume
author_sort Lanéelle, Damien
collection PubMed
description Background: Arterial Doppler Ultrasound waveform (DW) analysis allows the detection and evaluation of lower extremity peripheral artery disease. The high heterogeneity of the reported description of DW is reduced by the use of classification. However, the reliability of these classifications is either unknown or low to moderate and practices of vascular caregivers regarding the use of these classifications remain unknown. Aims: This study aims to assess the inter-observer reliability of the Saint-Bonnet classification, a 13-category DW classification. The secondary objective was to determine the utilization rate of the most common classifications and the ability of these classifications to describe DW. Methods: A national survey was conducted among all vascular physicians of French society of vascular medicine. They were invited by email to describe on a website 20 DW without and with the display of the Saint-Bonnet classification. The reliability of this classification was estimated by Fleiss' Kappa expressed with [95% confidence interval]. A semantic analysis allowed us to classify the physicians' responses according to the terms used. Finally we have evaluated for each classification the rate of misuse, i.e., the addition of a complementary term to the defined categories. Results: One hundred and ten physicians participated and only 5% of these were familiar with Saint-Bonnet classification. Fifty-four percent of vascular physicians used no classification at all. Vascular physicians used the Spronk (four-category), Descotes (five-category) and Saint-Bonnet (13-category) classifications for respectively, 31, 10, and 5%. Kappa coefficient of Fleiss (κ) was 0.546 [0.544–0.547] (p < 0.001). Reliability by category ranges from κ of 0.075 to 0.864. In multivariate analysis, the use of a classification was associated with fewer years of experience and was dependent on geographic location. Misuse rate by classification was 88, 82, and 5% using Spronk, Descotes and Saint-Bonnet classifications respectively. Conclusion: The reliability of Saint-Bonnet classification is weak to moderate by vascular physicians who are not familiar with its use. However, unlike the other classifications, it seems to be sufficiently precise so that the user does not need to complete its description. There is a significant heterogeneity in the use of arterial Doppler classifications in France.
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spelling pubmed-81850132021-06-09 Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians Lanéelle, Damien Guillaumat, Jérôme Trihan, Jean-Eudes Pottier, Camille Omarjee, Loukman Mahé, Guillaume Front Cardiovasc Med Cardiovascular Medicine Background: Arterial Doppler Ultrasound waveform (DW) analysis allows the detection and evaluation of lower extremity peripheral artery disease. The high heterogeneity of the reported description of DW is reduced by the use of classification. However, the reliability of these classifications is either unknown or low to moderate and practices of vascular caregivers regarding the use of these classifications remain unknown. Aims: This study aims to assess the inter-observer reliability of the Saint-Bonnet classification, a 13-category DW classification. The secondary objective was to determine the utilization rate of the most common classifications and the ability of these classifications to describe DW. Methods: A national survey was conducted among all vascular physicians of French society of vascular medicine. They were invited by email to describe on a website 20 DW without and with the display of the Saint-Bonnet classification. The reliability of this classification was estimated by Fleiss' Kappa expressed with [95% confidence interval]. A semantic analysis allowed us to classify the physicians' responses according to the terms used. Finally we have evaluated for each classification the rate of misuse, i.e., the addition of a complementary term to the defined categories. Results: One hundred and ten physicians participated and only 5% of these were familiar with Saint-Bonnet classification. Fifty-four percent of vascular physicians used no classification at all. Vascular physicians used the Spronk (four-category), Descotes (five-category) and Saint-Bonnet (13-category) classifications for respectively, 31, 10, and 5%. Kappa coefficient of Fleiss (κ) was 0.546 [0.544–0.547] (p < 0.001). Reliability by category ranges from κ of 0.075 to 0.864. In multivariate analysis, the use of a classification was associated with fewer years of experience and was dependent on geographic location. Misuse rate by classification was 88, 82, and 5% using Spronk, Descotes and Saint-Bonnet classifications respectively. Conclusion: The reliability of Saint-Bonnet classification is weak to moderate by vascular physicians who are not familiar with its use. However, unlike the other classifications, it seems to be sufficiently precise so that the user does not need to complete its description. There is a significant heterogeneity in the use of arterial Doppler classifications in France. Frontiers Media S.A. 2021-05-25 /pmc/articles/PMC8185013/ /pubmed/34113660 http://dx.doi.org/10.3389/fcvm.2021.640838 Text en Copyright © 2021 Lanéelle, Guillaumat, Trihan, Pottier, Omarjee, Mahé and SFMV PAD Study Group. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Lanéelle, Damien
Guillaumat, Jérôme
Trihan, Jean-Eudes
Pottier, Camille
Omarjee, Loukman
Mahé, Guillaume
Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians
title Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians
title_full Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians
title_fullStr Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians
title_full_unstemmed Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians
title_short Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians
title_sort inter-rater reliability of a 13-category arterial doppler waveform classification and practice of french vascular physicians
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8185013/
https://www.ncbi.nlm.nih.gov/pubmed/34113660
http://dx.doi.org/10.3389/fcvm.2021.640838
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