Evaluation of automated microvascular flow analysis software AVA 4: a validation study.

Autor: Guay CS; Department of Anesthesiology, Washington University School of Medicine in St. Louis, 660 S. Euclid Avenue, St Louis, MO, 63110, USA.; Department of Anesthesia and Critical Care Medicine, The Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Room 554, Montreal, QC, H3A 2B4, Canada., Khebir M; Department of Anesthesia and Critical Care Medicine, The Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Room 554, Montreal, QC, H3A 2B4, Canada.; Department of Anesthesia, McGill University, Montreal, QC, Canada., Shiva Shahiri T; Ingram School of Nursing, McGill University, Montreal, QC, Canada., Szilagyi A; Faculty of Medicine, McGill University, Montreal, QC, Canada., Cole EE; Clinical Research Unit, The Montreal Neurological Institute and Hospital, Montreal, QC, Canada., Simoneau G; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada., Badawy M; Department of Anesthesia and Critical Care Medicine, The Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Room 554, Montreal, QC, H3A 2B4, Canada. mohamed.badawy@mcgill.ca.; Department of Anesthesia, McGill University, Montreal, QC, Canada. mohamed.badawy@mcgill.ca.
Jazyk: angličtina
Zdroj: Intensive care medicine experimental [Intensive Care Med Exp] 2021 Apr 02; Vol. 9 (1), pp. 15. Date of Electronic Publication: 2021 Apr 02.
DOI: 10.1186/s40635-021-00380-0
Abstrakt: Background: Real-time automated analysis of videos of the microvasculature is an essential step in the development of research protocols and clinical algorithms that incorporate point-of-care microvascular analysis. In response to the call for validation studies of available automated analysis software by the European Society of Intensive Care Medicine, and building on a previous validation study in sheep, we report the first human validation study of AVA 4.
Methods: Two retrospective perioperative datasets of human microcirculation videos (P1 and P2) and one prospective healthy volunteer dataset (V1) were used in this validation study. Video quality was assessed using the modified Microcirculation Image Quality Selection (MIQS) score. Videos were initially analyzed with (1) AVA software 3.2 by two experienced investigators using the gold standard semi-automated method, followed by an analysis with (2) AVA automated software 4.1. Microvascular variables measured were perfused vessel density (PVD), total vessel density (TVD), and proportion of perfused vessels (PPV). Bland-Altman analysis and intraclass correlation coefficients (ICC) were used to measure agreement between the two methods. Each method's ability to discriminate between microcirculatory states before and after induction of general anesthesia was assessed using paired t-tests.
Results: Fifty-two videos from P1, 128 videos from P2 and 26 videos from V1 met inclusion criteria for analysis. Correlational analysis and Bland-Altman analysis revealed poor agreement and no correlation between AVA 4.1 and AVA 3.2. Following the induction of general anesthesia, TVD and PVD measured using AVA 3.2 increased significantly for P1 (p < 0.05) and P2 (p < 0.05). However, these changes could not be replicated with the data generated by AVA 4.1.
Conclusions: AVA 4.1 is not a suitable tool for research or clinical purposes at this time. Future validation studies of automated microvascular flow analysis software should aim to measure the new software's agreement with the gold standard, its ability to discriminate between clinical states and the quality thresholds at which its performance becomes unacceptable.
Databáze: MEDLINE
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