Reliability of the measurement of the abdominal aortic diameter by novice operators using a pocket-sized ultrasound system.
BACKGROUND
Despite favorable results of randomized studies and several guidelines, screening for abdominal aortic aneurysm is poorly implemented in most countries. In order to implement an effective abdominal aortic aneurysm screening programme, training of physicians other than cardiovascular imaging specialists is necessary. Also, the use of pocket-sized ultrasound systems seems an appealing alternative to conventional echography machines for large-scale screening.


OBJECTIVE
To test the hypothesis that, after a short period of specific training with a pocket-sized ultrasound system, novice operators could reliably measure the abdominal aortic diameter. We assessed the agreement between abdominal aortic diameter measurements from novice operators using a pocket-sized ultrasound system and experts using conventional machines.


METHODS
After focused training of novice operators, the abdominal aortic diameter was independently measured at least four times: by two experts using conventional ultrasound, by one expert using a pocket-sized ultrasound system and by at least one novice operator using the pocket-sized system; each operator was blinded to the others.


RESULTS
The aortic diameters of 56 patients were measured. The intraclass correlation coefficients between the four sets of measurement were all>0.91 and the mean difference between the measurements was negligible (<1mm). The interoperator variability for experts using conventional machines versus novices using pocket-sized machines was ≤ 4mm in 92.0% of cases. No learning curve over time was noted.


CONCLUSIONS
In order to screen for abdominal aortic aneurysm, the abdominal aortic diameter can be accurately measured by non-specialist physicians with pocket-sized ultrasound devices after a short period of training.
Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, 87042 Limoges cedex, France.
Tiphaine
T
Bonnafy
Philippe
P
Lacroix
Iléana
I
Desormais
Anaïs
A
Labrunie
Benoit
B
Marin
Aurélien
A
Leclerc
Aïda
A
Oueslati
Florence
F
Rollé
Philippe
P
Vignon
Victor
V
Aboyans
D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D014463:Ultrasonography
AAA; Abdominal aortic aneurysm; Anévrysme de l’aorte abdominale; CI; Dépistage; Experience; Expérience; Fiabilité; ICC; NHS; National Health Service; Reliability; Screening; Ultrasound; abdominal aortic aneurysm; confidence interval; intraclass correlation coefficient; Échographe de poche