Reliability of Echocardiographic Indicators of Pulmonary Vascular Disease in Preterm Infants at Risk for Bronchopulmonary Dysplasia
| Autor: | Peter M. Mourani, Marci K. Sontag, Adel K. Younoszai, Brenda B. Poindexter, Joshua I. Miller, Steven H. Abman, Michael DiMaria, Erin Carlton |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Article 03 medical and health sciences 0302 clinical medicine Risk Factors 030225 pediatrics medicine Humans Prospective Studies Vascular Diseases 030212 general & internal medicine Prospective cohort study Reliability (statistics) Bronchopulmonary Dysplasia Observer Variation business.industry Vascular disease Age Factors Infant Newborn Postmenstrual Age Reproducibility of Results Kappa score RV hypertrophy medicine.disease Pulmonary hypertension Bronchopulmonary dysplasia Echocardiography Pediatrics Perinatology and Child Health Female business Infant Premature |
| Zdroj: | The Journal of Pediatrics. 186:29-33 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/j.jpeds.2017.03.027 |
| Popis: | Objectives To determine the assessment and inter-rater reliability of echocardiographic evaluations of pulmonary vascular disease (PVD) in preterm infants at risk for bronchopulmonary dysplasia. Study design We prospectively studied echocardiograms from preterm infants (birthweights 500-1250 g) at 7 days of age and 36 weeks postmenstrual age (PMA). Echocardiograms were assessed by both a cardiologist on clinical service and a single research cardiologist. Interpretations were reviewed for inclusion of determinants of PVD and assessed for inter-rater reliability using the Prevalence Adjusted Bias Adjusted Kappa Score (PABAK). Results One hundred eighty and 188 matching research and clinical echocardiogram reports were available for the 7-day and 36-week PMA studies. At least one of the specific qualitative measures of PVD was missing from 54% of the clinical reports. PVD was diagnosed at 7 days in 31% and 20% of research and clinical interpretations, respectively (PABAK score of 0.54). At 36 weeks, PH was diagnosed in 15.6% and 17.8% of research and clinical interpretations, respectively (PABAK score of 0.80). Conclusions Although all qualitative variables of PVD are not consistently provided in echocardiogram reports, the inter-rater reliability of cardiologists evaluating measures of PVD revealed strong agreement, especially at 36 weeks PMA. We speculate that establishment of a protocol for echocardiographic evaluation may improve the identification of PVD in preterm infants. |
| Databáze: | OpenAIRE |
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