La Tour Medical Group, Geneva, Switzerland and University Hospitals of Geneva, Geneva, Switzerland.
Pediatric Emergency Medicine, Hospital for Sick Children and Department of Pediatrics, University of Toronto, Toronto, ON, M5G 1X8, Canada.
Childs Nerv Syst. 2022 Jul;38(7):1289-1295. doi: 10.1007/s00381-022-05510-x. Epub 2022 Apr 20.
To determine the interrater reliability of optic nerve sheath diameter (ONSD) and optic disc elevation (ODE) via ocular ultrasound by emergency and neurosurgery providers in children with ventricular shunts, and to explore the feasibility of acquiring and measuring images.
Two novices who underwent focused training and one expert in ocular ultrasound independently acquired images and measured ONSD and ODE on the same children, 0-18 years with ventricular shunts, blinded to each other's images and measurements. Patient tolerance, image quality, and time-to-complete exams were recorded. Images meeting a priori defined quality metrics were included. Mixed models and bootstrap analysis were used to obtain inter-rater reliability and 95% confidence intervals.
Eighty-one children were enrolled from August 2016 to July 2017, with mean age 9.6 years (SD 5.25, range 5 months-17.7 years). High-quality images (≥ 4 on 7-point quality Likert scale) were obtained in 83% of ONSD assessments and 95% of ODE assessments. The ICC was 0.82 (95% CI 0.76-0.91) for right eyes and 0.73 (95% CI 0.69-0.85) for left, while ICC was 0.81 (95% CI 0.75-0.89) for right eyes and 0.85 (95% CI 0.79-0.91) for left. Mean study duration (both eyes) was 2:52 min (SD 54 s).
Clinicians generated high-quality ocular ultrasound images with excellent interrater reliability when acquiring and measuring images of ONSD and ODE in children with ventricular shunts.
通过急诊和神经外科医生对脑室分流患儿进行眼部超声检查，确定视神经鞘直径（ONSD）和视盘抬高（ODE）的测量者间信度，并探讨获取和测量图像的可行性。
两名接受过重点培训的新手和一名眼部超声专家独立对 0-18 岁脑室分流患儿进行了检查，他们彼此之间并不知道对方的图像和测量结果。记录患者的耐受性、图像质量和完成检查的时间。仅纳入符合预先定义的质量标准的图像。采用混合模型和自举分析获得测量者间信度和 95%置信区间。
2016 年 8 月至 2017 年 7 月，共纳入 81 名患儿，平均年龄为 9.6 岁（标准差为 5.25 岁，范围为 5 个月-17.7 岁）。83%的 ONSD 评估和 95%的 ODE 评估获得了高质量的图像（7 分 Likert 量表≥4 分）。右眼的 ICC 为 0.82（95%可信区间 0.76-0.91），左眼的 ICC 为 0.73（95%可信区间 0.69-0.85），右眼的 ICC 为 0.81（95%可信区间 0.75-0.89），左眼的 ICC 为 0.85（95%可信区间 0.79-0.91）。双眼研究平均持续时间为 2:52 分钟（标准差为 54 秒）。
当对脑室分流患儿进行 ONSD 和 ODE 的图像采集和测量时，临床医生能够生成高质量的眼部超声图像，并且具有良好的测量者间信度。
