title: Successful novice's training in obtaining accurate assessment of carotid IMT using an automated ultrasound system.
abstract: OBJECTIVE
  The aim of this study was to assess the feasibility and learning curve of training novice operators in using automated ultrasound to achieve satisfactory carotid intima-media thickness (CIMT) measurements.
  
  
  RESULTS
  Four novices underwent 4 weeks carotid ultrasound training using a newly developed automated ultrasonograph. A longitudinal B-mode image of the distal right common carotid artery (CCA) was acquired in 96 patients. The interoperator CIMT reproducibility was analysed by the coefficient of variation (CV) and intraclass correlation coefficient (ICC) for every week and compared with that from an expert operator. The weekly mean CV of the measurements on the 24 patients made by all novices was consistently reduced: 0.06, 0.05, 0.03, and 0.02, respectively. For the expert, the mean CV was 0.02, 0.02, 0.03, and 0.02, respectively. The novices' standard deviation (SD) of CVs also reduced weekly from 0.04 in the first week to 0.01 in the last week (P < 0.05). The corresponding weekly variation in the SD for the expert was 0.02 for the first week to 0.01 in the last week (P = 0.27). The agreement between measurements made by the novices was expressed by the ICC being 0.97 (P < 0.001) in the first week and increased to 0.99 (P < 0.001) in the fourth week.
  
  
  CONCLUSIONS
  CIMT assessment by novices using an automated ultrasound could be reliably achievable after a short training period. These results may have encouraging implications when designing screening programmes for primary prevention in community health service.
authors.affiliation: Clinical Physiology, Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden davide.vanoli@medicin.umu.se davidevanoli@yahoo.com.
authors.forename: Davide
authors.initials: D
authors.lastname: Vanoli
authors.affiliation: Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden.
authors.forename: Urban
authors.initials: U
authors.lastname: Wiklund
authors.affiliation: Clinical Physiology, Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Lindqvist
authors.affiliation: Cardiology, Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Henein
authors.affiliation: Cardiology, Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Näslund
mesh_terms: D000328:Adult; D001331:Automation / Q000379:methods; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D002983:Clinical Competence; D004517:Education, Professional; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D018084:Ultrasonography, Interventional
keywords: Carotid artery; Health screening; Intima-media thickness; Vascular ultrasound