scholarly journals A focussed single-view hand-held echocardiography protocol for the detection of rheumatic heart disease – CORRIGENDUM

2017 ◽  
Vol 28 (4) ◽  
pp. 619-619
Author(s):  
Adriana Diamantino ◽  
Andrea Beaton ◽  
Twalib Aliku ◽  
Kaciane Oliveira ◽  
Cassio Oliveira ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Single View ◽  
Hand Held Echocardiography ◽  
Rheumatic Heart

A focussed single-view hand-held echocardiography protocol for the detection of rheumatic heart disease

2017 ◽  
Vol 28 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Adriana Diamantino ◽  
Andrea Beaton ◽  
Twalib Aliku ◽  
Kaciane Oliveira ◽  
Cassio Oliveira ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Negative Predictive Value ◽  
Rheumatic Heart Disease ◽  
Predictive Value ◽  
Aortic Insufficiency ◽  
Single View ◽  
Screening Protocol ◽  
Hand Held Echocardiography ◽  
Rheumatic Heart

AbstractBackgroundEchocardiographic screening represents an opportunity for reduction in the global burden of rheumatic heart disease. A focussed single-view screening protocol could allow for the rapid training of healthcare providers and screening of patients.ObjectiveThe aim of this study was to determine the sensitivity and specificity of a focussed single-view hand-held echocardiographic protocol for the diagnosis of rheumatic heart disease in children.MethodsA total of nine readers were divided into three reading groups; each interpreted 200 hand-held echocardiography studies retrospectively as screen-positive, if mitral regurgitation ⩾1.5 cm and/or any aortic insufficiency were observed, or screen-negative from a pooled study library. The performance of experts receiving focussed hand-held protocols, non-experts receiving focussed hand-held protocols, and experts receiving complete hand-held protocols were determined in comparison with consensus interpretations on fully functional echocardiography machines.ResultsIn all, 587 studies including 76 on definite rheumatic heart disease, 122 on borderline rheumatic heart disease, and 389 on normal cases were available for analysis. The focussed single-view protocol had a sensitivity of 81.1%, specificity of 75.5%, negative predictive value of 88.5%, and a positive predictive value of 63.2%; expert readers had higher specificity (86.1 versus 64.8%, p<0.01) but equal sensitivity. Sensitivity – experts, 96% and non-experts, 95% – and negative predictive value – experts, 99% and non-experts, 98% – were better for definite rheumatic heart disease. False-positive screening studies resulting from erroneous identification of mitral regurgitation and aortic insufficiency colour jets increased with shortened protocols and less experience (p<0.01).ConclusionOur data support a focussed screening protocol limited to parasternal long-axis images. This holds promise in making echocardiographic screening more practical in regions where rheumatic heart disease remains endemic.

scholarly journals Assessing The Performance Characteristics of Handheld Ultrasound in A Rheumatic Heart Disease Screening Program

2021 ◽  
Author(s):  
Zachary P. Kaltenborn ◽  
Zewde. Anteneh ◽  
Jonathan D. Kirsch ◽  
Michelle Yates ◽  
Katelyn M. Tessier ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Screening Program ◽  
P Value ◽  
Portable Ultrasound ◽  
Single View ◽  
Expert Review ◽  
Ultrasound Device ◽  
Handheld Ultrasound ◽  
Rheumatic Heart

Abstract Background Rheumatic heart disease affects 33 million people in low and middle income countries and is the leading cause of cardiovascular death among children and young adults. Penicillin prophylaxis has been shown to improve valvular function among patients with clinically silent or mild disease. Efforts to expand echocardiographic screening are focusing on simplified protocols, non-physician ultrasonographers, and portable ultrasound devices, including handheld ultrasound. Recent advances support the use of single-view screening protocols. With the increasing availability and low cost of handheld devices, prospective studies are needed to evaluate their performance in these settings. Methods We conducted a cross-sectional study among 19 at-risk school-children participating in a rheumatic heart disease screening program in Ethiopia comparing a handheld ultrasound device (Phillips Lumify) to a fully-equipped portable ultrasound machine (Sonosite M-Turbo). Results Agreement between devices was similar for expert and non-expert review (84%). However, when reviewed by a non-expert the Lumify identified fewer screen-positive cases (p-value 0.083). We also compared non-expert to expert interpretation by device and found a significant difference in interpretation for the Lumify (p-value 0.025). There was a trend towards shorter jet length by color Doppler in the handheld ultrasound device for both expert and non-expert review. Conclusions Our study highlights the importance of using caution when applying proposed single-view criteria as the sensitivity and specificity may be affected by the device.

Evaluation of a focussed protocol for hand-held echocardiography and computer-assisted auscultation in detecting latent rheumatic heart disease in scholars

2015 ◽  
Vol 26 (6) ◽  
pp. 1097-1106 ◽  
Author(s):  
Liesl J. Zühlke ◽  
Mark E. Engel ◽  
Simpiwe Nkepu ◽  
Bongani M. Mayosi
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Sensitivity And Specificity ◽  
Large Scale ◽  
High Specificity ◽  
Test Reliability ◽  
Computer Assisted ◽  
Asymptomatic Patients ◽  
Hand Held Echocardiography ◽  
Rheumatic Heart

AbstractIntroductionEchocardiography is the diagnostic test of choice for latent rheumatic heart disease. The utility of echocardiography for large-scale screening is limited by high cost, complex diagnostic protocols, and time to acquire multiple images. We evaluated the performance of a brief hand-held echocardiography protocol and computer-assisted auscultation in detecting latent rheumatic heart disease with or without pathological murmur.MethodsA total of 27 asymptomatic patients with latent rheumatic heart disease based on the World Heart Federation criteria and 66 healthy controls were examined by standard cardiac auscultation to detect pathological murmur. Hand-held echocardiography using a focussed protocol that utilises one view – that is, the parasternal long-axis view – and one measurement – that is, mitral regurgitant jet – and a computer-assisted auscultation utilising an automated decision tool were performed on all patients.ResultsThe sensitivity and specificity of computer-assisted auscultation in latent rheumatic heart disease were 4% (95% CI 1.0–20.4%) and 93.7% (95% CI 84.5–98.3%), respectively. The sensitivity and specificity of the focussed hand-held echocardiography protocol for definite rheumatic heart disease were 92.3% (95% CI 63.9–99.8%) and 100%, respectively. The test reliability of hand-held echocardiography was 98.7% for definite and 94.7% for borderline disease, and the adjusted diagnostic odds ratios were 1041 and 263.9 for definite and borderline disease, respectively.ConclusionComputer-assisted auscultation has extremely low sensitivity but high specificity for pathological murmur in latent rheumatic heart disease. Focussed hand-held echocardiography has fair sensitivity but high specificity and diagnostic utility for definite or borderline rheumatic heart disease in asymptomatic patients.

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