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首页> 外文期刊>Critical Ultrasound Journal >Interpretation errors in focused cardiac ultrasound by novice pediatric emergency medicine fellow sonologists
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Interpretation errors in focused cardiac ultrasound by novice pediatric emergency medicine fellow sonologists

机译：小儿急诊医学助理医师对聚焦心脏超声的解释错误

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Abstract BackgroundFocused cardiac ultrasound (FOCUS) is a core competency for pediatric emergency medicine (PEM) fellows. The objectives of this study were (1) to evaluate test characteristics of PEM-fellow-performed FOCUS for pericardial effusion and diminished cardiac function and (2) to assess image interpretation independent of image acquisition.MethodsPEM fellows performed and interpreted FOCUS on patients who also received cardiology service echocardiograms, the reference standard. Subsequently, eight different PEM fellows remotely interpreted a subset of the PEM-acquired and cardiology-acquired echocardiograms.ResultsEight PEM fellows performed 54 FOCUS exams, of which two had pericardial effusion and four had diminished function. PEM fellow FOCUS had a sensitivity of 50.0% (95% CI 9.19–90.8) and specificity of 100.0% (95% CI 91.1–100.0) for detecting diminished function, and sensitivity of 50.0% (95% CI 2.67–97.33) and specificity of 98.1% (95% CI 88.42–99.9) for detecting pericardial effusions. When PEM fellows remotely interpreted 15 echocardiograms, the sensitivity was 81.3% (95% CI 70.7–88.8) and specificity 75% (95% CI 67.0–81.0) for detecting diminished function, and sensitivity of 76.3% (95% CI 65.0–85.0) and specificity 94.4% (95% CI 89.0–97.0) for detecting pericardial effusion. There were no differences in sensitivity and specificity of PEM fellows’ interpretation of FOCUS studies compared to their interpretation of cardiology echocardiograms. Interrater reliability for interpretation of remote images (kappa) was 0.66 (95% CI 0.59–0.73) for effusion?and 0.31 (95% CI 0.24–0.38) for function among the fellows.ConclusionNovice PEM fellow sonologists (a physician who performs and interprets ultrasound) in the majority of instances were able to acquire and remotely interpret FOCUS images with limited training. However, they made real-time interpretation errors and likely need further training to incorporate real-time image acquisition and interpretation into their practice.
机译：摘要背景聚焦心脏超声（FOCUS）是小儿急诊医学（PEM）研究人员的一项核心能力。这项研究的目的是（1）评估PEM研究员执行的FOCUS对心包积液和心功能减退的测试特征，以及（2）评估与图像获取无关的图像解释。收到心脏病服务超声心动图，参考标准。随后，八名不同的PEM研究员远程解释了PEM采集和心脏病学超声心动图的子集。结果八名PEM研究员进行了54次FOCUS检查，其中两名进行了心包积液，而四名进行了功能减弱。 PEM同伴FOCUS对检测功能减弱的敏感度为50.0％（95％CI 9.19–90.8），特异性为100.0％（95％CI 91.1–100.0），对特异性的敏感度为50.0％（95％CI 2.67–97.33）。 98.1％（95％CI 88.42–99.9）用于检测心包积液。当PEM研究员远程解读15张超声心动图时，检测功能减弱的敏感性为81.3％（95％CI 70.7-88.8），特异性为75％（95％CI 67.0-81.0），灵敏度为76.3％（95％CI 65.0-85.0） ）和94.4％（95％CI 89.0–97.0）用于检测心包积液的特异性。与他们对心脏病超声心动图的解释相比，PEM研究员对FOCUS研究的解释的敏感性和特异性没有差异。研究员对远方图像（kappa）的解释的信度为0.66（95％CI 0.59–0.73），而渗出功能的可靠性为0.31（95％CI 0.24–0.38）。结论新手PEM超声医师（执行和解释的医师）在大多数情况下，只需进行有限的培训就可以获取和远程解释FOCUS图像。但是，他们犯了实时解释错误，可能需要进一步培训才能将实时图像获取和解释纳入他们的实践中。

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