title: Improving the reliability of venous Doppler flow measurements: relevance of combined ECG, training and repeated measures.
abstract: The nature of venous Doppler waves is highly variable. An additional electrocardiogram (ECG) improves the interpretation of venous Doppler wave characteristics and allows measurement of venous pulse transit time. The purpose of this study was to assess the reproducibility of ECG-guided repeated measurements of venous Doppler flow characteristics before and after sonographer training and the inter- and intra-observer variability. In four groups of 25 healthy women, venous Doppler flow measurements were performed at the level of the kidneys and liver according to a standardized protocol. Intra-observer Pearson correlation coefficients of the renal interlobar vein Doppler indices were ≥ 0.80 with the addition of the ECG, which are higher than the results of a former study. The inter-observer correlation between an experienced ultrasonographer and an inexperienced ultrasonographer improved from ≥ 0.71 to ≥ 0.91 after training. The correlation range of all parameters between two independent observers improved when values were based on repeated measures. The addition of an ECG to the Doppler image, training and repeated measurements are helpful in improving venous Doppler wave interpretation.
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium. Electronic address: anneleen.staelens@zol.be.
authors.forename: Anneleen S E
authors.initials: AS
authors.lastname: Staelens
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Tomsin
authors.affiliation: Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
authors.forename: Jolien
authors.initials: J
authors.lastname: Oben
authors.affiliation: Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
authors.forename: Tinne
authors.initials: T
authors.lastname: Mesens
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
authors.forename: Lars
authors.initials: L
authors.lastname: Grieten
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Gyselaers
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology*; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D015588:Observer Variation; D011247:Pregnancy / Q000502:physiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D014680:Veins / Q000000981:diagnostic imaging* / Q000502:physiology*
keywords: Doppler; Electrocardiogram; Pregnancy; Reliability; Repeated measurements; Reproducibility; Ultrasound