Scali Maria Chiara, de Azevedo Bellagamba Clarissa Carmona, Ciampi Quirino, Simova Iana, de Castro E Silva Pretto José Luis, Djordjevic-Dikic Ana, Dodi Claudio, Cortigiani Lauro, Zagatina Angela, Trambaiolo Paolo, Torres Marco R, Citro Rodolfo, Colonna Paolo, Paterni Marco, Picano Eugenio
Cardiology Division, Nottola Hospital, Siena, Italy.
Cardiothoracic Department, Cisanello, Pisa, Italy.
Int J Cardiovasc Imaging. 2017 Nov;33(11):1731-1736. doi: 10.1007/s10554-017-1167-2. Epub 2017 May 26.
The diffusion of smart-phones offers access to the best remote expertise in stress echo (SE). To evaluate the reliability of SE based on smart-phone filming and reading. A set of 20 SE video-clips were read in random sequence with a multiple choice six-answer test by ten readers from five different countries (Italy, Brazil, Serbia, Bulgaria, Russia) of the "SE2020" study network. The gold standard to assess accuracy was a core-lab expert reader in agreement with angiographic verification (0 = wrong, 1 = right). The same set of 20 SE studies were read, in random order and >2 months apart, on desktop Workstation and via smartphones by ten remote readers. Image quality was graded from 1 = poor but readable, to 3 = excellent. Kappa (k) statistics was used to assess intra- and inter-observer agreement. The image quality was comparable in desktop workstation vs. smartphone (2.0 ± 0.5 vs. 2.4 ± 0.7, p = NS). The average reading time per case was similar for desktop versus smartphone (90 ± 39 vs. 82 ± 54 s, p = NS). The overall diagnostic accuracy of the ten readers was similar for desktop workstation vs. smartphone (84 vs. 91%, p = NS). Intra-observer agreement (desktop vs. smartphone) was good (k = 0.81 ± 0.14). Inter-observer agreement was good and similar via desktop or smartphone (k = 0.69 vs. k = 0.72, p = NS). The diagnostic accuracy and consistency of SE reading among certified readers was high and similar via desktop workstation or via smartphone.
智能手机的普及使得人们能够获得压力超声心动图（SE）方面最优质的远程专业知识。为了评估基于智能手机拍摄和解读的SE的可靠性。“SE2020”研究网络中来自五个不同国家（意大利、巴西、塞尔维亚、保加利亚、俄罗斯）的十位读者，以随机顺序通过多项选择题六答案测试阅读了一组20个SE视频片段。评估准确性的金标准是与血管造影验证一致的核心实验室专家读者（0 = 错误，1 = 正确）。十位远程读者以随机顺序且间隔超过2个月，分别在台式工作站和通过智能手机阅读了同一组20项SE研究。图像质量从1（差但可读）到3（优秀）进行分级。使用Kappa（k）统计量来评估观察者内和观察者间的一致性。台式工作站与智能手机的图像质量相当（2.0±0.5对2.4±0.7，p = 无显著差异）。每个病例的平均阅读时间在台式机和智能手机上相似（90±39对82±54秒，p = 无显著差异）。十位读者在台式工作站和智能手机上的总体诊断准确性相似（84%对91%，p = 无显著差异）。观察者内一致性（台式机与智能手机）良好（k = 0.81±0.14）。观察者间一致性良好，通过台式机或智能手机的情况相似（k = 0.69对k = 0.72，p = 无显著差异）。在经过认证的读者中，SE解读的诊断准确性和一致性很高，通过台式工作站或智能手机的情况相似。
