title: Umbilical venous catheters placement evaluation on frontal radiogram: application of a simplified flow-chart for radiology residents.
abstract: BACKGROUND
  Umbilical Venous Catheter (UVC) are commonly used in neonatal period; they can be not correctly positioned and could be associated with complications. The purpose of this article is to suggest a flow-chart to evaluate the placement of UVC, testing it in young radiologists-in-training.
  
  
  METHODS
  We developed a simple flow-chart to asses, steps by step, UVC placement considering its course and tip location (ideally placed in the atriocaval junction). We tested the flow-chart impact asking to 20 residents to evaluate the placement of 10 UVC before and after they familiarized with the flow-chart and the anatomical findings of a newborn. The agreement among the 20 students was evaluated too.
  
  
  RESULTS
  The number of correct characterizations was different due to the administration of the flow-chart. One hundred and six correct UVC assessments at the beginning switched to 196 after the administration of the flow-chart (p = 0.0001). The observed agreement among the twenty radiology residents was statistically significant, both before (kappa = 0.41, p < 0.001) and after (kappa = 0.37, p < 0.001) the flow-chart administration.
  
  
  CONCLUSIONS
  The developed flow-chart demonstrated to be useful in increasing residents performance in UVC placement assessment.
authors.affiliation: Section of Radiological Sciences, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy. sergio.salerno@unipa.it.
authors.forename: Sergio
authors.identifier: http://orcid.org/0000-0003-1020-3437
authors.initials: S
authors.lastname: Salerno
authors.affiliation: Section of Radiological Sciences, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Tudisca
authors.affiliation: Section of Radiological Sciences, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Murmura
authors.affiliation: Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy.
authors.forename: Domenica
authors.initials: D
authors.lastname: Matranga
authors.affiliation: Section of Radiological Sciences, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Tona
authors.affiliation: Section of Radiological Sciences, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Re
authors.affiliation: Section of Radiological Sciences, DIBIMED, University of Palermo, Via del Vespro 127, 90127, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lo Casto
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D002405:Catheterization, Central Venous / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D011859:Radiography; D011871:Radiology / Q000193:education*; D012985:Software Design; D014471:Umbilical Veins
keywords: Flow-chart; Frontal radiogram; Radiology resident; Umbilical venous catheter