Department of Internal Medicine, University of Colorado Hospital, 12631 E 17th Avenue, Aurora, CO, 80045, USA.
Department of Emergency Medicine, University of Colorado Hospital, Aurora, CO, USA.
Crit Care. 2024 Jun 11;28(1):197. doi: 10.1186/s13054-024-04961-9.
Though the novel venous excess ultrasound (VExUS) score is increasingly used as a noninvasive means of venous congestion measurement, the inter-rater reliability (IRR), inter-user reproducibility (IUR), and utility of concurrent ECG have not been evaluated. We conducted a multicenter study of the IRR, IUR, and utility of ECG for VExUS interpretation between four attending physicians of diverse specialties, reporting the Kappa statistic (KS) and Intraclass Correlation Coefficient (ICC) for IRR and IUR for scans with and without ECG. Eighty-four paired VExUS exams from 42 patients, 60 of which had a concurrent ECG tracing, were interpreted. They showed substantial IRR, with a KS of 0.71 and ICC of 0.83 for the overall VExUS grade (p < 0.001), and IUR, with a KS 0.63 and ICC of 0.8. There was greater agreement among images with an ECG tracing. These results suggest that ECG-augmented VExUS may be a reliable and reproducible measure interpretable by clinicians with diverse backgrounds.
尽管新型静脉淤血超声（VExUS）评分越来越多地被用作静脉淤血的非侵入性测量手段，但尚未评估其观察者间可靠性（IRR）、观察者内可重复性（IUR）和心电图的实用性。我们进行了一项多中心研究，评估了四位不同专业主治医生之间的 VExUS 解释的 IRR、IUR 和心电图的实用性，报告了 Kappa 统计量（KS）和无心电图和有心电图扫描的 IRR 和 IUR 的组内相关系数（ICC）。对 42 名患者的 84 对 VExUS 检查进行了分析，其中 60 对有同步心电图描记。结果显示，整体 VExUS 评分的 IRR 具有中等程度的一致性，KS 为 0.71，ICC 为 0.83（p<0.001），IUR 也具有中等程度的一致性，KS 为 0.63，ICC 为 0.8。有心电图描记的图像之间的一致性更大。这些结果表明，心电图增强的 VExUS 可能是一种可靠且可重复的测量手段，可由具有不同背景的临床医生进行解读。
