BACKGROUND/AIMS: Fibroscan allows liver stiffness examination (LSE) that is well correlated with fibrosis stages. Our main objective was to evaluate LSE learning curve. METHODS: LSE results of five novice observers with different medical status were compared with those of five expert observers (physicians with >100 examinations) in 250 patients with chronic liver disease. Each novice-expert pair had to blindly examine 50 consecutive patients divided into five consecutive subgroups of 10 patients. RESULTS: In each observer group, novice-expert agreement [intraclass correlation coefficient (Ric)] for LSE results was excellent from the first to the last subgroup. Novice-expert agreement for LSE results varied with liver stiffness level: <9 kPa: Ric=0.49; >or=9 kPa: Ric=0.87. Relative difference (%) between novice and expert LSE results was independently associated with the number of valid LSE measurements, and stabilizes around 20-30% after the fourth valid measurement. In each observer group, novice-expert agreement (Ric) for LSE success rate progressively increased as a function of time. CONCLUSION: LSE requires no learning curve: a novice is able to obtain a reliable result after a single training session, whatever the professional status. However, success rate will progressively increase. An LSE with less than four valid measurements should not be considered as reliable.
BACKGROUND/AIMS: Fibroscan allows liver stiffness examination (LSE) that is well correlated with fibrosis stages. Our main objective was to evaluate LSE learning curve. METHODS: LSE results of five novice observers with different medical status were compared with those of five expert observers (physicians with >100 examinations) in 250 patients with chronic liver disease. Each novice-expert pair had to blindly examine 50 consecutive patients divided into five consecutive subgroups of 10 patients. RESULTS: In each observer group, novice-expert agreement [intraclass correlation coefficient (Ric)] for LSE results was excellent from the first to the last subgroup. Novice-expert agreement for LSE results varied with liver stiffness level: <9 kPa: Ric=0.49; >or=9 kPa: Ric=0.87. Relative difference (%) between novice and expert LSE results was independently associated with the number of valid LSE measurements, and stabilizes around 20-30% after the fourth valid measurement. In each observer group, novice-expert agreement (Ric) for LSE success rate progressively increased as a function of time. CONCLUSION: LSE requires no learning curve: a novice is able to obtain a reliable result after a single training session, whatever the professional status. However, success rate will progressively increase. An LSE with less than four valid measurements should not be considered as reliable.
Authors: Cristina Felicani; Chiara De Molo; Horia Stefanescu; Fabio Conti; Elena Mazzotta; Veronica Gabusi; Elena Nardi; Antonio Maria Morselli-Labate; Pietro Andreone; Carla Serra Journal: J Ultrasound Date: 2018-05-22
Authors: C Busca; M Sánchez-Conde; M Rico; M Rosas; E Valencia; A Moreno; V Moreno; L Martín-Carbonero; S Moreno; I Pérez-Valero; J I Bernardino; J R Arribas; J González; A Olveira; P Castillo; M Abadía; L Guerra; C Mendez; M L Montes Journal: Open Forum Infect Dis Date: 2022-06-09 Impact factor: 4.423
Authors: Yingzhen N Zhang; Kathryn J Fowler; Arinc Ozturk; Chetan K Potu; Ashley L Louie; Vivian Montes; Walter C Henderson; Kang Wang; Michael P Andre; Anthony E Samir; Claude B Sirlin Journal: J Magn Reson Imaging Date: 2019-03-12 Impact factor: 4.813
Authors: M J Armstrong; C Corbett; J Hodson; N Marwah; R Parker; D D Houlihan; I A Rowe; J M Hazlehurst; R Brown; S G Hübscher; D Mutimer Journal: Postgrad Med J Date: 2013-08-07 Impact factor: 2.401