TY - JOUR
T1 - Transesophageal echocardiography interpretation
T2 - A comparative analysis between cardiac anesthesiologists and primary echocardiographers
AU - Mathew, Joseph P.
AU - Fontes, Manuel L.
AU - Garwood, Susan
AU - Davis, Elizabeth
AU - White, William D.
AU - McCloskey, Gerard
AU - Fitch, Jane C K
AU - Afifi, Sherif
AU - Lee, David L.
AU - Kraker, Phillip
AU - Rafferty, Terence D.
AU - Barash, Paul G.
AU - Gillam, Linda
AU - Prokop, Edward
PY - 2002
Y1 - 2002
N2 - Diagnostic interpretation of intraoperative transesophageal echocardiography (TEE) examinations may vary, particularly when the echocardiographer is also the anesthesiologist. We therefore evaluated the concordance of TEE interpretation as part of a process of continuous quality improvement (CQI). Ten cardiac anesthesiologists participating in a CQI program conducted 154 comprehensive TEE examinations, each consisting of 16 major fields describing cardiac anatomy and function. These examinations were subsequently interpreted offline by two primary echocardiographers (a radiologist and a cardiologist). Agreement was assessed using the K coefficient and percent agreement. Overall K and percent agreement were 0.58 and 83% for anesthesiologists versus radiologist, 0.57 and 80% for anesthesiologists versus cardiologist, and 0.60 and 82% for radiologist versus cardiologist. Anesthesiologists with longer than 5 yr of TEE experience had higher levels of agreement with the radiologist when assessing the aorta, right atrium, pulmonary vein flow, transmitral flow, and fractional area change. Cardiac anesthesiologists supported by a CQI program interpret TEE examinations at a level comparable with physicians whose primary practice is echocardiography. Thus, the anesthesiologist and the intraoperative echocardiographer need not be mutually exclusive.
AB - Diagnostic interpretation of intraoperative transesophageal echocardiography (TEE) examinations may vary, particularly when the echocardiographer is also the anesthesiologist. We therefore evaluated the concordance of TEE interpretation as part of a process of continuous quality improvement (CQI). Ten cardiac anesthesiologists participating in a CQI program conducted 154 comprehensive TEE examinations, each consisting of 16 major fields describing cardiac anatomy and function. These examinations were subsequently interpreted offline by two primary echocardiographers (a radiologist and a cardiologist). Agreement was assessed using the K coefficient and percent agreement. Overall K and percent agreement were 0.58 and 83% for anesthesiologists versus radiologist, 0.57 and 80% for anesthesiologists versus cardiologist, and 0.60 and 82% for radiologist versus cardiologist. Anesthesiologists with longer than 5 yr of TEE experience had higher levels of agreement with the radiologist when assessing the aorta, right atrium, pulmonary vein flow, transmitral flow, and fractional area change. Cardiac anesthesiologists supported by a CQI program interpret TEE examinations at a level comparable with physicians whose primary practice is echocardiography. Thus, the anesthesiologist and the intraoperative echocardiographer need not be mutually exclusive.
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U2 - 10.1213/00000539-200202000-00013
DO - 10.1213/00000539-200202000-00013
M3 - Article
C2 - 11812688
AN - SCOPUS:0036154977
SN - 0003-2999
VL - 94
SP - 302
EP - 309
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 2
ER -