title: Impact of clinical training on supra-aortic duplex and transcranial doppler examination concordance.
abstract: Sonographic tests are observer-dependent. With 1,527 consecutive patients, 22 trainees were assessed at baseline and after a hands-on 1:1 program, with a pre-examination median of 76 studies/trainee. We evaluated the required number of supervised examinations to reach a 0.80 kappa index (ki). Statistics included linear and exponential generalized estimating equation models. In the exponential model, 76 studies for carotid-duplex and >102 for vertebral-duplex and transcranial Doppler were needed for a 0.80 ki. "Relevant-categories" after-training ki was 0.80 in carotid-duplex and transcranial Doppler but 0.60 in vertebral-duplex. A fixed training does not guarantee a high ki. Measuring the acquired skills of every trainee would improve quality. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:571-579, 2016.
authors.affiliation: Stroke Unit and Neurosonology Laboratory, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdSSC), Madrid, Spain. jegidoh@yahoo.com.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Egido
authors.affiliation: Acute Stroke Unit, Worcestershire Royal Hospital, Worcester, United Kingdom.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Garcia
authors.affiliation: Unidad de Apoyo a la Investigación, Servicio de Medicina Preventiva, IdSSC, UAX, Madrid, Spain.
authors.forename: Náyade
authors.initials: N
authors.lastname: Del Prado-Gonzalez
authors.affiliation: Unidad de Apoyo a la Investigación, Servicio de Medicina Preventiva, IdSSC, UAX, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Fuentes-Ferrer
authors.affiliation: Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Lopez-Herranz
authors.affiliation: Stroke Unit and Neurosonology Laboratory, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdSSC), Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Simal-Hernández
authors.affiliation: Unidad de Apoyo a la Investigación. Servicio de Medicina Preventiva, IdSSC, UCM, UAX, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández-Pérez
mesh_terms: D001011:Aorta / Q000000981:diagnostic imaging; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002983:Clinical Competence / Q000706:statistics & numerical data*; D015331:Cohort Studies; D006801:Humans; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D014465:Ultrasonics / Q000193:education*; D018616:Ultrasonography, Doppler, Duplex / Q000706:statistics & numerical data*; D017585:Ultrasonography, Doppler, Transcranial / Q000706:statistics & numerical data*; D014711:Vertebral Artery / Q000000981:diagnostic imaging
keywords: accuracy; agreement; neurosonology; quality; training