Visual Estimation of Bedside Echocardiographic Ejection Fraction by Emergency Physicians
Introduction: The objective of this study was to determine whether bedside visual estimates of left ventricular systolic function (LVSF) by emergency physicians (EP) would agree with quantitative measurement of LVSF by the modified Simpson’s method (MSM), as recommended by the American Society of Ec...
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2014-02-01
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| Series: | Western Journal of Emergency Medicine |
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| Online Access: | http://escholarship.org/uc/item/7xc4w5d2# |
| _version_ | 1818228819149979648 |
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| author | Erden E. Ünlüer Arif Karagöz Haldun Akoglu Serdar Bayata |
| author_facet | Erden E. Ünlüer Arif Karagöz Haldun Akoglu Serdar Bayata |
| author_sort | Erden E. Ünlüer |
| collection | DOAJ |
| description | Introduction: The objective of this study was to determine whether bedside visual estimates of left ventricular systolic function (LVSF) by emergency physicians (EP) would agree with quantitative measurement of LVSF by the modified Simpson’s method (MSM), as recommended by the American Society of Echocardiography.
Methods: After limited focused training, 2 trained EPs performed bedside echocardiography (BECH) procedures s between January and June 2012 to prospectively evaluate patients presenting to the emergency department (ED) with dyspnea. EPs categorized their visually estimated ejection fractions (VEF) as either low or normal. Formal echocardiography were ordered and performed by an experienced cardiologist using the MSM and accepted as the criterion standard. We compared BECH results for each EP using chi-squared testing and performed correlation analysis by Pearson correlation coefficient.
Results: Of the 146 enrolled patients with dyspnea, 13 were excluded and 133 were included in the study. Comparison of EPs vs. cardiologist’s estimate of ejection fraction yielded a Pearson’s correlation coefficient of 0.77 (R, p<0.0001) and 0.78 (R, p<0.0001). Calculated biserial correlations using point-biserial correlation and z-scores were 1 (rb, p<0.0001) for both EPs. The agreement between EPs and the cardiologist was 0.861 and 0.876, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and the positive and negative likelihood ratios for each physician were 98.7-98.7%, 86.2-87.9%, 0.902-0.914, 0.980-0.981, 7.153-8.175, 0.015-0.015, respectively.
Conclusion: EPs with a focused training in limited BECH can assess LVSF accurately in the ED by visual estimation. [West J Emerg Med. 2014;15(2):221–226.] |
| first_indexed | 2024-12-12T10:08:46Z |
| format | Article |
| id | doaj.art-a925a376315a4aa3b54e5720d4309380 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-900X |
| language | English |
| last_indexed | 2024-12-12T10:08:46Z |
| publishDate | 2014-02-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-a925a376315a4aa3b54e5720d43093802022-12-22T00:27:52ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-900X2014-02-0115222122610.5811/westjem.2013.9.16185Visual Estimation of Bedside Echocardiographic Ejection Fraction by Emergency PhysiciansErden E. Ünlüer0Arif Karagöz1Haldun Akoglu2Serdar Bayata3Izmir Katip Çelebi University Atatürk Research and Training Hospital, TurkeyIzmir Katip Çelebi University Atatürk Research and Training Hospital, TurkeyKartal Lütfi Kirdar Research and Training Hospital, TurkeyIzmir Katip Çelebi University Atatürk Research and Training Hospital, TurkeyIntroduction: The objective of this study was to determine whether bedside visual estimates of left ventricular systolic function (LVSF) by emergency physicians (EP) would agree with quantitative measurement of LVSF by the modified Simpson’s method (MSM), as recommended by the American Society of Echocardiography. Methods: After limited focused training, 2 trained EPs performed bedside echocardiography (BECH) procedures s between January and June 2012 to prospectively evaluate patients presenting to the emergency department (ED) with dyspnea. EPs categorized their visually estimated ejection fractions (VEF) as either low or normal. Formal echocardiography were ordered and performed by an experienced cardiologist using the MSM and accepted as the criterion standard. We compared BECH results for each EP using chi-squared testing and performed correlation analysis by Pearson correlation coefficient. Results: Of the 146 enrolled patients with dyspnea, 13 were excluded and 133 were included in the study. Comparison of EPs vs. cardiologist’s estimate of ejection fraction yielded a Pearson’s correlation coefficient of 0.77 (R, p<0.0001) and 0.78 (R, p<0.0001). Calculated biserial correlations using point-biserial correlation and z-scores were 1 (rb, p<0.0001) for both EPs. The agreement between EPs and the cardiologist was 0.861 and 0.876, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and the positive and negative likelihood ratios for each physician were 98.7-98.7%, 86.2-87.9%, 0.902-0.914, 0.980-0.981, 7.153-8.175, 0.015-0.015, respectively. Conclusion: EPs with a focused training in limited BECH can assess LVSF accurately in the ED by visual estimation. [West J Emerg Med. 2014;15(2):221–226.]http://escholarship.org/uc/item/7xc4w5d2#Visual estimationejection fractionbedside echocardiographyHealth scienceEmergency Medicine |
| spellingShingle | Erden E. Ünlüer Arif Karagöz Haldun Akoglu Serdar Bayata Visual Estimation of Bedside Echocardiographic Ejection Fraction by Emergency Physicians Western Journal of Emergency Medicine Visual estimation ejection fraction bedside echocardiography Health science Emergency Medicine |
| title | Visual Estimation of Bedside Echocardiographic Ejection Fraction by Emergency Physicians |
| title_full | Visual Estimation of Bedside Echocardiographic Ejection Fraction by Emergency Physicians |
| title_fullStr | Visual Estimation of Bedside Echocardiographic Ejection Fraction by Emergency Physicians |
| title_full_unstemmed | Visual Estimation of Bedside Echocardiographic Ejection Fraction by Emergency Physicians |
| title_short | Visual Estimation of Bedside Echocardiographic Ejection Fraction by Emergency Physicians |
| title_sort | visual estimation of bedside echocardiographic ejection fraction by emergency physicians |
| topic | Visual estimation ejection fraction bedside echocardiography Health science Emergency Medicine |
| url | http://escholarship.org/uc/item/7xc4w5d2# |
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