Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV, USA.
Touro University Nevada College of Osteopathic Medicine, Henderson, NV, USA.
Vasc Health Risk Manag. 2023 Apr 6;19:223-230. doi: 10.2147/VHRM.S400117. eCollection 2023.
In the United States, echocardiography is an essential component of the care of many cardiac patients. Recently, increased attention has been given to the accuracy of interpretation of cardiac-based procedures in different specialties, amongst them the field of cardiac anesthesiology and primary echocardiographers for transesophageal echocardiogram (TEE). The purpose of this study was to assess the TEE skills of cardiac anesthesiologists in comparison to primary echocardiographers, either radiologists or cardiologists. In this systematic review, we evaluated available current literature to identify if cardiac anesthesiologists interpret TEE procedures at an identical level to that of primary echocardiographers.
A PRISMA systematic review was utilized from PubMed from the years 1952-2022. A broad keyword search of "Cardiology Anesthesiology Echocardiogram" and "Echocardiography Anesthesiology" to identify the literature was used. From reviewing 1798 articles, there were a total of 9 studies included in our systematic review, 3 of which yielded quantitative data and 6 of which yielded qualitative data. The mean accuracy from each of these three qualitative studies was calculated and used to represent the overall accuracy of cardiac anesthesiologists.
Through identified studies, a total of 8197 TEEs were interpreted by cardiac anesthesiologists with a concordance rate of 84% to the interpretations of primary echocardiographers. Cardiac anesthesiologists had a concordance rate of 83% when compared to radiologists. On the other hand, cardiac anesthesiologists and cardiologists had a concordance rate of 87% in one study and 79% in another study.
Based on these studies, cardiac anesthesiologists are shown to interpret TEEs similarly to that of primary echocardiographers. At this time, there is no gold standard to evaluate the accuracy of TEE readings. One way to address this is to individually assess the TEE interpretation of anesthesiologists and primary echocardiographers with a double-blind study.
在美国，超声心动图是许多心脏病患者护理的重要组成部分。最近，人们越来越关注不同专业领域中心脏相关程序解释的准确性，其中包括心脏麻醉学领域和经食管超声心动图（TEE）的初级超声心动图医师。本研究的目的是评估心脏麻醉师与初级超声心动图医师（放射科医师或心脏病专家）相比的 TEE 技能。在这项系统评价中，我们评估了现有的文献，以确定心脏麻醉师是否能够达到与初级超声心动图医师相同的 TEE 程序解释水平。
我们使用 PRISMA 系统评价方法从 1952 年至 2022 年的 PubMed 中进行了检索。使用“Cardiology Anesthesiology Echocardiogram”和“Echocardiography Anesthesiology”的广泛关键字搜索来识别文献。在审查了 1798 篇文章后，共有 9 项研究纳入了我们的系统评价，其中 3 项研究提供了定量数据，6 项研究提供了定性数据。从这三项定性研究中的每一项中计算出平均准确性，并用于代表心脏麻醉师的整体准确性。
通过确定的研究，共有 8197 次 TEE 由心脏麻醉师进行解读，与初级超声心动图医师的一致性率为 84%。与放射科医师相比，心脏麻醉师的一致性率为 83%。另一方面，在一项研究中，心脏麻醉师和心脏病专家的一致性率为 87%，而在另一项研究中为 79%。
根据这些研究，心脏麻醉师解读 TEE 的能力与初级超声心动图医师相似。目前，没有评估 TEE 读数准确性的金标准。一种解决方法是通过双盲研究单独评估麻醉师和初级超声心动图医师的 TEE 解读。
