title: Agreement between community echocardiography and hospital echocardiography in patients suspected of having left ventricular systolic dysfunction.
abstract: BACKGROUND
  Smaller echocardiography machines, when used in hospitals, are accurate for detecting left ventricular dysfunction and valvular disease. This paper assessed the detection of left ventricular dysfunction and of valvular disease in the community setting by a smaller machine.
  
  
  OBJECTIVE
  To measure the agreement in patients with suspected heart failure between community echocardiography and traditional echocardiography in the hospital in detecting left ventricular dysfunction and significant valve disease.
  
  
  METHODS
  Suspected heart failure patients were referred to one of the authors (SJ) for community echocardiography using a Siemens Cypress machine. The patients had a second echocardiogram in the hospital by another sonographer who was blinded to the results of the first echocardiogram. The reports of the two sonographers were assessed for agreement using kappa statistics.
  
  
  RESULTS
  458 patients had a community echocardiogram and 136 agreed to a second echocardiogram in the hospital. There was excellent agreement, kappa = 0.87 (0.06 SE), for the detection of left ventricular dysfunction between community echocardiography and the hospital machine. The detection of significant valvular disease was good, kappa = 0.75 (0.06) between the community echocardiogram and hospital machines.
  
  
  CONCLUSIONS
  In suspected heart failure patients, community echocardiography gives comparable results to traditional hospital echocardiography for left ventricular dysfunction detection and for significant valvular disease detection.
authors.affiliation: Department of Cardiology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK. sjeyaseelan@doctors.org.uk
authors.forename: S
authors.initials: S
authors.lastname: Jeyaseelan
authors.forename: B M
authors.initials: BM
authors.lastname: Goudie
authors.forename: S D
authors.initials: SD
authors.lastname: Pringle
authors.forename: P T
authors.initials: PT
authors.lastname: Donnan
authors.forename: F M
authors.initials: FM
authors.lastname: Sullivan
authors.forename: A D
authors.initials: AD
authors.lastname: Struthers
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000592:standards; D003153:Community Health Services / Q000592:standards*; D018618:Echocardiography, Doppler, Color / Q000295:instrumentation / Q000592:standards; D005260:Female; D006333:Heart Failure; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging; D006760:Hospitalization; D006801:Humans; D008297:Male; D015588:Observer Variation; D012606:Scotland; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*