Ultrasound core laboratory for the Household Air Pollution Intervention Network trial: standardized training and image management for field studies using portable ultrasound in fetal, lung, and vascular evaluations

Ultrasound Core Laboratories (UCL) are used in multicenter trials to assess imaging biomarkers to define robust phenotypes, to reduce imaging variability and to allow blinded independent review with the purpose of optimizing endpoint measurement precision. The Household Air Pollution Intervention Ne...

Full description

Bibliographic Details
Main Authors: Dávila-Román, VG, Toenjes, AK, Meyers, RM, Lenzen, PM, Simkovich, SM, Herrera, P, Fung, E, Papageorghiou, AT, Craik, R, McCracken, JP, Thompson, LM, Balakrishnan, K, Rosa, G, Peel, J, Clasen, TF, Hossen, S, Checkley, W, Fuentes, LDL
Other Authors: HAPIN Investigators
Format: Journal article
Language:English
Published: Elsevier 2021
_version_ 1797063932620308480
author Dávila-Román, VG
Toenjes, AK
Meyers, RM
Lenzen, PM
Simkovich, SM
Herrera, P
Fung, E
Papageorghiou, AT
Craik, R
McCracken, JP
Thompson, LM
Balakrishnan, K
Rosa, G
Peel, J
Clasen, TF
Hossen, S
Checkley, W
Fuentes, LDL
author2 HAPIN Investigators
author_facet HAPIN Investigators
Dávila-Román, VG
Toenjes, AK
Meyers, RM
Lenzen, PM
Simkovich, SM
Herrera, P
Fung, E
Papageorghiou, AT
Craik, R
McCracken, JP
Thompson, LM
Balakrishnan, K
Rosa, G
Peel, J
Clasen, TF
Hossen, S
Checkley, W
Fuentes, LDL
author_sort Dávila-Román, VG
collection OXFORD
description Ultrasound Core Laboratories (UCL) are used in multicenter trials to assess imaging biomarkers to define robust phenotypes, to reduce imaging variability and to allow blinded independent review with the purpose of optimizing endpoint measurement precision. The Household Air Pollution Intervention Network, a multicountry randomized controlled trial (Guatemala, Peru, India and Rwanda), evaluates the effects of reducing household air pollution on health outcomes. Field studies using portable ultrasound evaluate fetal, lung and vascular imaging endpoints. The objective of this report is to describe administrative methods and training of a centralized clinical research UCL. A comprehensive administrative protocol and training curriculum included standard operating procedures, didactics, practical scanning and written/practical assessments of general ultrasound principles and specific imaging protocols. After initial online training, 18 sonographers (three or four per country and five from the UCL) participated in a 2 wk on-site training program. Written and practical testing evaluated ultrasound topic knowledge and scanning skills, and surveys evaluated the overall course. The UCL developed comprehensive standard operating procedures for image acquisition with a portable ultrasound system, digital image upload to cloud-based storage, off-line analysis and quality control. Pre- and post-training tests showed significant improvements (fetal ultrasound: 71% ± 13% vs. 93% ± 7%, p < 0.0001; vascular lung ultrasound: 60% ± 8% vs. 84% ± 10%, p < 0.0001). Qualitative and quantitative feedback showed high satisfaction with training (mean, 4.9 ± 0.1; scale: 1 = worst, 5 = best). The UCL oversees all stages: training, standardization, performance monitoring, image quality control and consistency of measurements. Sonographers who failed to meet minimum allowable performance were identified for retraining. In conclusion, a UCL was established to ensure accurate and reproducible ultrasound measurements in clinical research. Standardized operating procedures and training are aimed at reducing variability and enhancing measurement precision from study sites, representing a model for use of portable digital ultrasound for multicenter field studies.
first_indexed 2024-03-06T21:07:03Z
format Journal article
id oxford-uuid:3cd4fc11-b54e-4650-9eb4-7b22a9026f30
institution University of Oxford
language English
last_indexed 2024-03-06T21:07:03Z
publishDate 2021
publisher Elsevier
record_format dspace
spelling oxford-uuid:3cd4fc11-b54e-4650-9eb4-7b22a9026f302022-03-26T14:15:56ZUltrasound core laboratory for the Household Air Pollution Intervention Network trial: standardized training and image management for field studies using portable ultrasound in fetal, lung, and vascular evaluationsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3cd4fc11-b54e-4650-9eb4-7b22a9026f30EnglishSymplectic ElementsElsevier2021Dávila-Román, VGToenjes, AKMeyers, RMLenzen, PMSimkovich, SMHerrera, PFung, EPapageorghiou, ATCraik, RMcCracken, JPThompson, LMBalakrishnan, KRosa, GPeel, JClasen, TFHossen, SCheckley, WFuentes, LDLHAPIN InvestigatorsUltrasound Core Laboratories (UCL) are used in multicenter trials to assess imaging biomarkers to define robust phenotypes, to reduce imaging variability and to allow blinded independent review with the purpose of optimizing endpoint measurement precision. The Household Air Pollution Intervention Network, a multicountry randomized controlled trial (Guatemala, Peru, India and Rwanda), evaluates the effects of reducing household air pollution on health outcomes. Field studies using portable ultrasound evaluate fetal, lung and vascular imaging endpoints. The objective of this report is to describe administrative methods and training of a centralized clinical research UCL. A comprehensive administrative protocol and training curriculum included standard operating procedures, didactics, practical scanning and written/practical assessments of general ultrasound principles and specific imaging protocols. After initial online training, 18 sonographers (three or four per country and five from the UCL) participated in a 2 wk on-site training program. Written and practical testing evaluated ultrasound topic knowledge and scanning skills, and surveys evaluated the overall course. The UCL developed comprehensive standard operating procedures for image acquisition with a portable ultrasound system, digital image upload to cloud-based storage, off-line analysis and quality control. Pre- and post-training tests showed significant improvements (fetal ultrasound: 71% ± 13% vs. 93% ± 7%, p < 0.0001; vascular lung ultrasound: 60% ± 8% vs. 84% ± 10%, p < 0.0001). Qualitative and quantitative feedback showed high satisfaction with training (mean, 4.9 ± 0.1; scale: 1 = worst, 5 = best). The UCL oversees all stages: training, standardization, performance monitoring, image quality control and consistency of measurements. Sonographers who failed to meet minimum allowable performance were identified for retraining. In conclusion, a UCL was established to ensure accurate and reproducible ultrasound measurements in clinical research. Standardized operating procedures and training are aimed at reducing variability and enhancing measurement precision from study sites, representing a model for use of portable digital ultrasound for multicenter field studies.
spellingShingle Dávila-Román, VG
Toenjes, AK
Meyers, RM
Lenzen, PM
Simkovich, SM
Herrera, P
Fung, E
Papageorghiou, AT
Craik, R
McCracken, JP
Thompson, LM
Balakrishnan, K
Rosa, G
Peel, J
Clasen, TF
Hossen, S
Checkley, W
Fuentes, LDL
Ultrasound core laboratory for the Household Air Pollution Intervention Network trial: standardized training and image management for field studies using portable ultrasound in fetal, lung, and vascular evaluations
title Ultrasound core laboratory for the Household Air Pollution Intervention Network trial: standardized training and image management for field studies using portable ultrasound in fetal, lung, and vascular evaluations
title_full Ultrasound core laboratory for the Household Air Pollution Intervention Network trial: standardized training and image management for field studies using portable ultrasound in fetal, lung, and vascular evaluations
title_fullStr Ultrasound core laboratory for the Household Air Pollution Intervention Network trial: standardized training and image management for field studies using portable ultrasound in fetal, lung, and vascular evaluations
title_full_unstemmed Ultrasound core laboratory for the Household Air Pollution Intervention Network trial: standardized training and image management for field studies using portable ultrasound in fetal, lung, and vascular evaluations
title_short Ultrasound core laboratory for the Household Air Pollution Intervention Network trial: standardized training and image management for field studies using portable ultrasound in fetal, lung, and vascular evaluations
title_sort ultrasound core laboratory for the household air pollution intervention network trial standardized training and image management for field studies using portable ultrasound in fetal lung and vascular evaluations
work_keys_str_mv AT davilaromanvg ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT toenjesak ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT meyersrm ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT lenzenpm ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT simkovichsm ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT herrerap ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT funge ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT papageorghiouat ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT craikr ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT mccrackenjp ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT thompsonlm ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT balakrishnank ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT rosag ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT peelj ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT clasentf ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT hossens ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT checkleyw ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations
AT fuentesldl ultrasoundcorelaboratoryforthehouseholdairpollutioninterventionnetworktrialstandardizedtrainingandimagemanagementforfieldstudiesusingportableultrasoundinfetallungandvascularevaluations