title: An integrated software system for quality assurance-related kappa coefficient analysis of intraoperative transesophageal echocardiography interpretive skills.
abstract: This report describes the development of a quality assurance-oriented integrated software system designed for an anesthesiology-based intraoperative transesophageal echocardiography service. Entry data include patient and operation demographics, two-dimensional echocardiographic, saline-contrast, and color flow/pulsed Doppler assessments of the heart and great vessels, presented in a defined sequence. A statistical analysis component (kappa coefficient analysis) allows for comparison of intraoperative real-time interpretations with laboratory interpretations made by experienced full-time echocardiographers on a field-by-field basis. This provides a means of quantifying expertise in each individual aspect of the patient examination sequence. We believe that such self-appraisal data are essential for delineating the status and tracking the progress of service being provided.
authors.affiliation: Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: T
authors.initials: T
authors.lastname: Rafferty
authors.forename: B
authors.initials: B
authors.lastname: Edwards
authors.forename: J
authors.initials: J
authors.lastname: Judd
authors.forename: V
authors.initials: V
authors.lastname: Swamy
authors.forename: R
authors.initials: R
authors.lastname: Workman
authors.forename: H
authors.initials: H
authors.lastname: Lippmann
authors.forename: S
authors.initials: S
authors.lastname: Harris
authors.forename: I
authors.initials: I
authors.lastname: Cohen
authors.forename: E
authors.initials: E
authors.lastname: Prokop
authors.forename: M
authors.initials: M
authors.lastname: Ezekowitz
mesh_terms: D017548:Echocardiography, Transesophageal / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016343:Monitoring, Intraoperative / Q000379:methods*; D015588:Observer Variation; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012984:Software