Quirino Ciampi1, Eugenio Picano2, Marco Paterni3, Clarissa Borguezan Daros4, Iana Simova5, José Luis de Castro E Silva Pretto6, Maria Chiara Scali7, Nicola Gaibazzi8, Sergio Severino9, Ana Djordjevic-Dikic10, Jaroslaw D Kasprzak11, Angela Zagatina12, Albert Varga13, Jorge Lowenstein14, Pablo Martin Merlo14, Miguel Amor15, Jelena Celutkiene16, Julio E Perez17, Giovanni Di Salvo18, Maurizio Galderisi19, Fabio Mori20, Marco Fabio Costantino21, Laura Massa22, Milica Dekleva23, Daniel Quesada Chaves24, Paolo Trambaiolo25, Rodolfo Citro26, Paolo Colonna27, Fausto Rigo28, Marco A R Torres29, Ines Monte30, Ivan Stankovic31, Aleksander Neskovic31, Lauro Cortigiani32, Federica Re33, Claudio Dodi34, Antonello D'Andrea35, Bruno Villari36, Ayana Arystan3, Michele De Nes3, Clara Carpeggiani3. 1. CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy; Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy. 2. CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy. Electronic address: picano@ifc.cnr.it. 3. CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy. 4. Cardiology Division, Hospital San José, Criciuma, Brazil. 5. Acibadem City Clinic Cardiovascular Center, University Hospital, Sofia, Bulgaria. 6. Hospital Sao Vicente de Paulo e Hospital de Cidade, Passo Fundo, Brazil. 7. Cardiology Department, Nottola Hospital, Siena, and Cardiothoracic Department, University of Pisa, Italy. 8. Cardiology Department, Parma University Hospital, Italy. 9. Cardiology Department, Monaldi Hospital, Naples, Italy. 10. Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Serbia. 11. Chair of Cardiology, Bieganski Hospital, Medical University, Lodz, Poland. 12. Cardiology Department, Medika Cardiocenter, Saint Petersburg, Russian Federation. 13. Institute of Family Medicine, University of Szeged, Hungary. 14. Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina. 15. Cardiology Department, Ramos Mejia Hospital, Buenos Aires, Argentina. 16. Centre of Cardiology and Angiology, Vilnius University Hospital Santariškių Klinicos, Lithuania. 17. Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, MO, USA. 18. Pediatric Cardiology Department, Brompton Hospital, London, UK. 19. Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy. 20. Cardiology Department, Careggi Hospital, Florence, Italy. 21. Cardiology Department, San Carlo Hospital, Potenza, Italy. 22. Cardiology Department, University Hospital "Ospedale Riuniti", Trieste, Italy. 23. Clinical Hospital Zvezdara Belgrade, Serbia. 24. Hospital San Vicente de Paul, Heredia, Costa Rica. 25. Department of Cardiology, Sandro Pertini Hospital, Rome, Italy. 26. Cardiology Department and Echocardiography Lab, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy. 27. Cardiology Hospital, Policlinico of Bari, Italy. 28. Cardiology Department, Ospedale dell'Angelo Mestre-, Venice, Italy. 29. Hospital de Clinicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. 30. Cardio-Thorax-Vascular Department, Echocardiography Lab, "Policlinico Vittorio Emanuele", Catania University, Italy. 31. Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Serbia. 32. Cardiology Department, San Luca Hospital, Lucca, Italy. 33. Cardiology Department, San Camillo-Forlanini Hospital, Roma, Italy. 34. Casa di Cura Figlie di San Camillo, Cremona, Italy. 35. Cardiology Department, Echocardiography Lab, Monaldi Hospital, Second University of Naples, Italy. 36. Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy.
Abstract
BACKGROUND: The trial "Stress Echo (SE) 2020" evaluates novel applications of SE beyond coronary artery disease. The aim of the study was control quality and harmonize reading criteria. METHODS: One reader from 78 centers of the SE 2020 network asked for credentials to read a set of 20 SE video-clips selected by the core lab. All aspiring centers met the pre-requisite of high-volume and the years of experience in SE ranged from 5 to 31years (mean value 18years). The diagnostic gold standard was a reading by the core lab. The a priori determined pass threshold was 18/20 (≥90%). RESULTS: Of the initial 78 who started, 57 completed the first attempt: individual readers' score on first attempt ranged from 07/20 to 20/20 (accuracy from 35% to 100%, mean 78.7±13%) and 44 readers passed it. There was a very poor correlation between years of experience and the reader's score on first attempt (r=-0.161, p=0.231). Of the 13 readers who failed the first attempt, 12 took it again after the web-based session and their accuracy improved (74% vs. 96%, p<0.001). The kappa inter-observer agreement before and after web-based training was 0.59 on first attempt and rose to 0.91 on the last attempt. CONCLUSIONS: In SE reading, the volume of activity or years of experience is not synonymous with diagnostic quality. Qualitative analysis and operator-dependence can become a limiting weakness in clinical practice, in the absence of strict pathways of learning, credentialing and audit.
BACKGROUND: The trial "Stress Echo (SE) 2020" evaluates novel applications of SE beyond coronary artery disease. The aim of the study was control quality and harmonize reading criteria. METHODS: One reader from 78 centers of the SE 2020 network asked for credentials to read a set of 20 SE video-clips selected by the core lab. All aspiring centers met the pre-requisite of high-volume and the years of experience in SE ranged from 5 to 31years (mean value 18years). The diagnostic gold standard was a reading by the core lab. The a priori determined pass threshold was 18/20 (≥90%). RESULTS: Of the initial 78 who started, 57 completed the first attempt: individual readers' score on first attempt ranged from 07/20 to 20/20 (accuracy from 35% to 100%, mean 78.7±13%) and 44 readers passed it. There was a very poor correlation between years of experience and the reader's score on first attempt (r=-0.161, p=0.231). Of the 13 readers who failed the first attempt, 12 took it again after the web-based session and their accuracy improved (74% vs. 96%, p<0.001). The kappa inter-observer agreement before and after web-based training was 0.59 on first attempt and rose to 0.91 on the last attempt. CONCLUSIONS: In SE reading, the volume of activity or years of experience is not synonymous with diagnostic quality. Qualitative analysis and operator-dependence can become a limiting weakness in clinical practice, in the absence of strict pathways of learning, credentialing and audit.
Authors: Eugenio Picano; Quirino Ciampi; Lauro Cortigiani; Adelaide M Arruda-Olson; Clarissa Borguezan-Daros; José Luis de Castro E Silva Pretto; Rosangela Cocchia; Eduardo Bossone; Elisa Merli; Garvan C Kane; Albert Varga; Gergely Agoston; Maria Chiara Scali; Doralisa Morrone; Iana Simova; Martina Samardjieva; Alla Boshchenko; Tamara Ryabova; Alexander Vrublevsky; Attila Palinkas; Eszter D Palinkas; Robert Sepp; Marco A R Torres; Hector R Villarraga; Tamara Kovačević Preradović; Rodolfo Citro; Miguel Amor; Hugo Mosto; Michael Salamè; Paul Leeson; Cristina Mangia; Nicola Gaibazzi; Domenico Tuttolomondo; Costantina Prota; Jesus Peteiro; Caroline M Van De Heyning; Antonello D'Andrea; Fausto Rigo; Aleksandra Nikolic; Miodrag Ostojic; Jorge Lowenstein; Rosina Arbucci; Diego M Lowenstein Haber; Pablo M Merlo; Karina Wierzbowska-Drabik; Jaroslaw D Kasprzak; Maciej Haberka; Ana Cristina Camarozano; Nithima Ratanasit; Fabio Mori; Maria Grazia D'Alfonso; Luigi Tassetti; Alessandra Milazzo; Iacopo Olivotto; Alberto Marchi; Hugo Rodriguez-Zanella; Angela Zagatina; Ratnasari Padang; Milica Dekleva; Ana Djordievic-Dikic; Nikola Boskovic; Milorad Tesic; Vojislav Giga; Branko Beleslin; Giovanni Di Salvo; Valentina Lorenzoni; Matteo Cameli; Giulia Elena Mandoli; Tonino Bombardini; Pio Caso; Jelena Celutkiene; Andrea Barbieri; Giovanni Benfari; Ylenia Bartolacelli; Alessandro Malagoli; Francesca Bursi; Francesca Mantovani; Bruno Villari; Antonello Russo; Michele De Nes; Clara Carpeggiani; Ines Monte; Federica Re; Carlos Cotrim; Giuseppe Bilardo; Ariel K Saad; Arnas Karuzas; Dovydas Matuliauskas; Paolo Colonna; Francesco Antonini-Canterin; Mauro Pepi; Patricia A Pellikka Journal: J Clin Med Date: 2021-08-17 Impact factor: 4.964
Authors: Hugo Rodriguez-Zanella; Rosina Arbucci; Juan Francisco Fritche-Salazar; Xochitl Arely Ortiz-Leon; Domenico Tuttolomondo; Diego Haber Lowenstein; Karina Wierzbowska-Drabik; Quirino Ciampi; Jarosław D Kasprzak; Nicola Gaibazzi; Jorge Lowenstein; Edith Liliana Posada-Martinez; Jose Antonio Arias-Godinez; Juan C de la Fuente-Mancera; Eugenio Picano Journal: J Clin Med Date: 2022-01-28 Impact factor: 4.241
Authors: Maria Chiara Scali; Quirino Ciampi; Eugenio Picano; Eduardo Bossone; Francesco Ferrara; Rodolfo Citro; Paolo Colonna; Marco Fabio Costantino; Lauro Cortigiani; Antonello D' Andrea; Sergio Severino; Claudio Dodi; Nicola Gaibazzi; Maurizio Galderisi; Andrea Barbieri; Ines Monte; Fabio Mori; Barbara Reisenhofer; Federica Re; Fausto Rigo; Paolo Trambaiolo; Miguel Amor; Jorge Lowenstein; Pablo Martin Merlo; Clarissa Borguezan Daros; José Luis de Castro E Silva Pretto; Marcelo Haertel Miglioranza; Marco A R Torres; Clarissa Carmona de Azevedo Bellagamba; Daniel Quesada Chaves; Iana Simova; Albert Varga; Jelena Čelutkienė; Jaroslaw D Kasprzak; Karina Wierzbowska-Drabik; Piotr Lipiec; Paulina Weiner-Mik; Eva Szymczyk; Katarzyna Wdowiak-Okrojek; Ana Djordjevic-Dikic; Milica Dekleva; Ivan Stankovic; Aleksandar N Neskovic; Angela Zagatina; Giovanni Di Salvo; Julio E Perez; Ana Cristina Camarozano; Anca Irina Corciu; Alla Boshchenko; Fabio Lattanzi; Carlos Cotrim; Paula Fazendas; Maciej Haberka; Bozena Sobkowic; Wojciech Kosmala; Tomasz Witkowski; Piotr Gosciniak; Alessandro Salustri; Hugo Rodriguez-Zanella; Luis Ignacio Martin Leal; Alexandra Nikolic; Suzana Gligorova; Madalina-Loredana Urluescu; Maria Fiorino; Giuseppina Novo; Tamara Preradovic-Kovacevic; Miodrag Ostojic; Branko Beleslin; Bruno Villari; Michele De Nes; Marco Paterni; Clara Carpeggiani Journal: Cardiovasc Ultrasound Date: 2018-09-25 Impact factor: 2.062
Authors: Quirino Ciampi; Iacopo Olivotto; Jesus Peteiro; Maria Grazia D'Alfonso; Fabio Mori; Luigi Tassetti; Alessandra Milazzo; Lorenzo Monserrat; Xusto Fernandez; Attila Pálinkás; Eszter Dalma Pálinkás; Róbert Sepp; Federica Re; Lauro Cortigiani; Milorad Tesic; Ana Djordjevic-Dikic; Branko Beleslin; Mariangela Losi; Grazia Canciello; Sandro Betocchi; Luis Rocha Lopes; Ines Cruz; Carlos Cotrim; Marco A R Torres; Clarissa C A Bellagamba; Caroline M Van De Heyning; Albert Varga; Gergely Ágoston; Bruno Villari; Valentina Lorenzoni; Clara Carpeggiani; Eugenio Picano Journal: J Clin Med Date: 2021-03-24 Impact factor: 4.241