Can we improve transthoracic echocardiography training in non-cardiologist residents? Experience of two training programs in the intensive care unit

Labbé, Vincent; Ederhy, Stéphane; Pasquet, Blandine; Miguel-Montanes, Romain; Rafat, Cédric; Hajage, David; Gaudry, Stéphane; Dreyfuss, Didier; Cohen, Ariel; Fartoukh, Muriel; Ricard, Jean-Damien

doi:10.1186/s13613-016-0150-8

Annals of Intensive Care

Table 4 Answers to semiquantitative and qualitative clinical questions by residents and the expert

From: Can we improve transthoracic echocardiography training in non-cardiologist residents? Experience of two training programs in the intensive care unit

Semiquantitative and qualitative clinical questions^a	Resident accuracy, % Sens/Spe/PPV/NPV		Expert’s positive results, n (%)		Agreement between residents and expert, κ (95 % CI)
Semiquantitative and qualitative clinical questions^a	Group I	Group II	Group I	Group II	Group I	Group II	p*
Global LV systolic function (n = 136/ n = 156)
Any dysfunction	96/85/75/97	93/92/79/97	45 (33)	42 (26)	0.75 (0.64–0.86)	0.77 (0.66–0.88)	0.93
Severe dysfunction	58/96/69/93	93/99/93/99	19 (14)	15 (9)	0.57 (0.37–0.78)	0.93 (0.82–1)	0.004
Heterogeneous LV contraction (n = 115/n = 136)	65/89/71/85	19/80/50/49	34 (30)	41 (30)	0.55 (0.38–0.72)	0.49 (0.33–0.65)	0.54
RV dilatation (n = 133/n = 152)
Any dilatation	56/90/56/90	80/89/73/93	25 (19)	40 (26)	0.46 (0.27–0.65)	0.67 (0.54–0.80)	0.08
Severe dilatation	55/99/86/96	88/98/70/99	11 (8)	8 (5)	0.64 (0.38–0.91)	0.80 (0.56–0.96)	0.35
Paradoxical septum (−/n = 150)	–	50/100/100/97	–	10 (7)	–	0.65 (0.37–0.93)	–
Significant LS valve disease (n = 119/n = 146)	55/95/69/91	91/95/76/98	16 (13)	21 (15)	0.54 (0.33–0.75)	0.79 (0.66–0.93)	0.02
Significant MR (n = 127/n = 145)	50//98/40/98	80/96/57/99	4 (3)	10 (7)	0.42 (0.01–0.84)	0.64 (0.40–0.87)	0.42
Significant MS (n = 116/n = 145)	50/100/100/98	67/100/100/99	4 (3)	3 (2)	0.66 (0.22–1)	0.80 (0.41–1)	0.41
Significant AR (n = 128/n = 141)	0/98/0/98	100/100/100/100	3 (2)	2 (2)	–0.02 (–0.04–0)	1	0.001
Significant AS (n = 112/n = 143)	60/100/100/98	86/100/100/99	5 (4)	7 (5)	0.74 (0.40–1)	0.92 (0.76–1)	0.37
Pericardial effusion (n = 133/n = 157)
Any	87/94/62/99	93/96/68/99	13 (8)	14 (9)	0.83 (0.67–0.99)	0.76 (0.60–0.93)	0.59
Significant	100/100/100/100	100/100/100/100	8 (6)	7 (4)	1	1	–
Tamponade	–	100/100/100/100	0	2 (1)	–	1	–
Significant respiratory variations of IVC diameter (n = 76/n = 116)	53/95/75/88	42/84/59/72	17 (22)	41 (35)	0.53 (0.30–0.77)	0.27 (0.09–0.45)	0.09

AR aortic regurgitation, AS aortic stenosis, CI confidence interva, LV left ventricular, IVC inferior vena cava, LS left-sided, MR mitral regurgitation, MS mitral stenosis, NPV negative predictive value, PPV positive predictive value, RV right ventricular
* Comparison of κ values between group I and group II
^aThe number of comparisons is noted for each clinical question and for each group (group I/group II)

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