title: Use of an automatic application for wall motion classification based on longitudinal strain: is it affected by operator expertise in echocardiography? A multicentre study by the Israeli Echocardiography Research Group.
abstract: OBJECTIVE
  Assessing the quality of wall motion (WM) on echocardiograms remains a challenge. Previously, we validated an automated application used by experienced echocardiographers for WM classification based on longitudinal two-dimensional (2D) strain. The aim of this study was to show that the use of this automatic application was independent of the user's experience.
  
  
  RESULTS
  We compared the WM classifications obtained by the application when used by 12 highly experienced readers (Exp-R) vs. 11 inexperienced readers (InExp-R). Both classifications were compared with expert consensus classifications using the standard visual method. Digitized clips of cardiac cycles from three apical views in 105 patients were used for these analyses. Reproducibility of both groups was high (overall intra-class correlation coefficient: InExp-R = 0.89, Exp-R = 0.83); the lowest was noted for hypokinetic segments (InExp-R = 0.79, Exp-R = 0.72). InExp-R scores were concordant with Exp-R mode scores in 88.8% of segments; they were overestimated in 5.8% and underestimated in 3.2%. The sensitivity, specificity, and accuracy of InExp-R vs. Exp-R for classifying segments as normal/abnormal were identical (87, 85, and 86%, respectively).
  
  
  CONCLUSIONS
  Classification of WM from apical views with an automatic application based on longitudinal 2D strain by InExp-R vs. Exp-R was similar to visual classification by Exp-R. This application may be useful for inexperienced echocardiographers/technicians and may serve as an automated 'second opinion' for experienced echocardiographers.
authors: Non-invasive Cardiology Unit, Hillel-Yaffe Medical Center, Hadera, Israel. dsblond@gmail.com
authors: David S
authors: DS
authors: Blondheim
authors: Zvi
authors: Z
authors: Friedman
authors: Peter
authors: P
authors: Lysyansky
authors: Rafael
authors: R
authors: Kuperstein
authors: Ilan
authors: I
authors: Hay
authors: Micha S
authors: MS
authors: Feinberg
authors: Ronen
authors: R
authors: Beeri
authors: Mordehay
authors: M
authors: Vaturi
authors: Alik
authors: A
authors: Sagie
authors: Sarah
authors: S
authors: Shimoni
authors: Wolfgang
authors: W
authors: Fehske
authors: Lisa
authors: L
authors: Deutsch
authors: Marina
authors: M
authors: Leitman
authors: Dan
authors: D
authors: Gilon
authors: Yoram
authors: Y
authors: Agmon
authors: Yossi
authors: Y
authors: Tsadok
authors: David
authors: D
authors: Rosenmann
authors: Noah
authors: N
authors: Liel-Cohen
mesh_terms: D003936:Diagnosis, Computer-Assisted; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012984:Software; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*