Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis

<p> Assessing 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 sonograp...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Bilal Albaroudi (16122219) (author)
مؤلفون آخرون: Mahmoud Haddad (16122230) (author), Omar Albaroudi (16122240) (author), Manar E. Abdel-Rahman (16122263) (author), Robert Jarman (15278335) (author), Tim Harris (717778) (author)
منشور في: 2021
الموضوعات:
الوسوم: إضافة وسم
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author Bilal Albaroudi (16122219)
author2 Mahmoud Haddad (16122230)
Omar Albaroudi (16122240)
Manar E. Abdel-Rahman (16122263)
Robert Jarman (15278335)
Tim Harris (717778)
author2_role author
author
author
author
author
author_facet Bilal Albaroudi (16122219)
Mahmoud Haddad (16122230)
Omar Albaroudi (16122240)
Manar E. Abdel-Rahman (16122263)
Robert Jarman (15278335)
Tim Harris (717778)
author_role author
dc.creator.none.fl_str_mv Bilal Albaroudi (16122219)
Mahmoud Haddad (16122230)
Omar Albaroudi (16122240)
Manar E. Abdel-Rahman (16122263)
Robert Jarman (15278335)
Tim Harris (717778)
dc.date.none.fl_str_mv 2021-09-03T00:00:00Z
dc.identifier.none.fl_str_mv 10.1097/mej.0000000000000866
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Assessing_left_ventricular_systolic_function_by_emergency_physician_using_point_of_care_echocardiography_compared_to_expert_systematic_review_and_meta-analysis/23380835
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
adult
cardiologists
echocardiography
emergency medicine
left ventricular dysfunction
meta-analysis
observer variation
point-of-care systems
sensitivity and specificity
systematic review
dc.title.none.fl_str_mv Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p> Assessing 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, EMBASE, Cochrane, ClinicalTrials.gov, TRIP 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. </p> <h2>Other Information</h2> <p>Published in: European Journal of Emergency Medicine<br> License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br> See article on publisher's website: <a href="http://dx.doi.org/10.1097/mej.0000000000000866" target="_blank">http://dx.doi.org/10.1097/mej.0000000000000866</a></p>
eu_rights_str_mv openAccess
id Manara2_6cdcc88bb1713aea47d7a60fe70e318d
identifier_str_mv 10.1097/mej.0000000000000866
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/23380835
publishDate 2021
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spelling Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysisBilal Albaroudi (16122219)Mahmoud Haddad (16122230)Omar Albaroudi (16122240)Manar E. Abdel-Rahman (16122263)Robert Jarman (15278335)Tim Harris (717778)Biomedical and clinical sciencesClinical sciencesMathematical sciencesStatisticsadultcardiologistsechocardiographyemergency medicineleft ventricular dysfunctionmeta-analysisobserver variationpoint-of-care systemssensitivity and specificitysystematic review<p> Assessing 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, EMBASE, Cochrane, ClinicalTrials.gov, TRIP 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. </p> <h2>Other Information</h2> <p>Published in: European Journal of Emergency Medicine<br> License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br> See article on publisher's website: <a href="http://dx.doi.org/10.1097/mej.0000000000000866" target="_blank">http://dx.doi.org/10.1097/mej.0000000000000866</a></p>2021-09-03T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1097/mej.0000000000000866https://figshare.com/articles/journal_contribution/Assessing_left_ventricular_systolic_function_by_emergency_physician_using_point_of_care_echocardiography_compared_to_expert_systematic_review_and_meta-analysis/23380835CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/233808352021-09-03T00:00:00Z
spellingShingle Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis
Bilal Albaroudi (16122219)
Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
adult
cardiologists
echocardiography
emergency medicine
left ventricular dysfunction
meta-analysis
observer variation
point-of-care systems
sensitivity and specificity
systematic review
status_str publishedVersion
title Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis
title_full Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis
title_fullStr Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis
title_full_unstemmed Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis
title_short Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis
title_sort Assessing left ventricular systolic function by emergency physician using point of care echocardiography compared to expert: systematic review and meta-analysis
topic Biomedical and clinical sciences
Clinical sciences
Mathematical sciences
Statistics
adult
cardiologists
echocardiography
emergency medicine
left ventricular dysfunction
meta-analysis
observer variation
point-of-care systems
sensitivity and specificity
systematic review