Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study

Abstract With an urgent need for bedside imaging of coronavirus disease 2019 (COVID-19), this study’s main goal was to assess inter- and intraobserver agreement in lung ultrasound (LUS) of COVID-19 patients. In this single-center study we prospectively acquired and evaluated 100 recorded ten-second...

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Autores principales:	Markus H. Lerchbaumer, Jonathan H. Lauryn, Ulrike Bachmann, Philipp Enghard, Thomas Fischer, Jana Grune, Niklas Hegemann, Dmytro Khadzhynov, Jan Matthias Kruse, Lukas J. Lehner, Tobias Lindner, Timur Oezkan, Daniel Zickler, Wolfgang M. Kuebler, Bernd Hamm, Kai-Uwe Eckardt, Frédéric Muench
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dee357e9df8041a7b493097d29fd7cbc
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spelling	oai:doaj.org-article:dee357e9df8041a7b493097d29fd7cbc2021-12-02T16:51:26ZPoint-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study10.1038/s41598-021-90153-22045-2322https://doaj.org/article/dee357e9df8041a7b493097d29fd7cbc2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90153-2https://doaj.org/toc/2045-2322Abstract With an urgent need for bedside imaging of coronavirus disease 2019 (COVID-19), this study’s main goal was to assess inter- and intraobserver agreement in lung ultrasound (LUS) of COVID-19 patients. In this single-center study we prospectively acquired and evaluated 100 recorded ten-second cine-loops in confirmed COVID-19 intensive care unit (ICU) patients. All loops were rated by ten observers with different subspeciality backgrounds for four times by each observer (400 loops overall) in a random sequence using a web-based rating tool. We analyzed inter- and intraobserver variability for specific pathologies and a semiquantitative LUS score. Interobserver agreement for both, identification of specific pathologies and assignment of LUS scores was fair to moderate (e.g., LUS score 1 Fleiss’ κ = 0.27; subpleural consolidations Fleiss’ κ = 0.59). Intraobserver agreement was mostly moderate to substantial with generally higher agreement for more distinct findings (e.g., lowest LUS score 0 vs. highest LUS score 3 (median Fleiss’ κ = 0.71 vs. 0.79) or air bronchograms (median Fleiss’ κ = 0.72)). Intraobserver consistency was relatively low for intermediate LUS scores (e.g. LUS Score 1 median Fleiss’ κ = 0.52). We therefore conclude that more distinct LUS findings (e.g., air bronchograms, subpleural consolidations) may be more suitable for disease monitoring, especially with more than one investigator and that training material used for LUS in point-of-care ultrasound (POCUS) should pay refined attention to areas such as B-line quantification and differentiation of intermediate LUS scores.Markus H. LerchbaumerJonathan H. LaurynUlrike BachmannPhilipp EnghardThomas FischerJana GruneNiklas HegemannDmytro KhadzhynovJan Matthias KruseLukas J. LehnerTobias LindnerTimur OezkanDaniel ZicklerWolfgang M. KueblerBernd HammKai-Uwe EckardtFrédéric MuenchNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Markus H. Lerchbaumer Jonathan H. Lauryn Ulrike Bachmann Philipp Enghard Thomas Fischer Jana Grune Niklas Hegemann Dmytro Khadzhynov Jan Matthias Kruse Lukas J. Lehner Tobias Lindner Timur Oezkan Daniel Zickler Wolfgang M. Kuebler Bernd Hamm Kai-Uwe Eckardt Frédéric Muench Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study
description	Abstract With an urgent need for bedside imaging of coronavirus disease 2019 (COVID-19), this study’s main goal was to assess inter- and intraobserver agreement in lung ultrasound (LUS) of COVID-19 patients. In this single-center study we prospectively acquired and evaluated 100 recorded ten-second cine-loops in confirmed COVID-19 intensive care unit (ICU) patients. All loops were rated by ten observers with different subspeciality backgrounds for four times by each observer (400 loops overall) in a random sequence using a web-based rating tool. We analyzed inter- and intraobserver variability for specific pathologies and a semiquantitative LUS score. Interobserver agreement for both, identification of specific pathologies and assignment of LUS scores was fair to moderate (e.g., LUS score 1 Fleiss’ κ = 0.27; subpleural consolidations Fleiss’ κ = 0.59). Intraobserver agreement was mostly moderate to substantial with generally higher agreement for more distinct findings (e.g., lowest LUS score 0 vs. highest LUS score 3 (median Fleiss’ κ = 0.71 vs. 0.79) or air bronchograms (median Fleiss’ κ = 0.72)). Intraobserver consistency was relatively low for intermediate LUS scores (e.g. LUS Score 1 median Fleiss’ κ = 0.52). We therefore conclude that more distinct LUS findings (e.g., air bronchograms, subpleural consolidations) may be more suitable for disease monitoring, especially with more than one investigator and that training material used for LUS in point-of-care ultrasound (POCUS) should pay refined attention to areas such as B-line quantification and differentiation of intermediate LUS scores.
format	article
author	Markus H. Lerchbaumer Jonathan H. Lauryn Ulrike Bachmann Philipp Enghard Thomas Fischer Jana Grune Niklas Hegemann Dmytro Khadzhynov Jan Matthias Kruse Lukas J. Lehner Tobias Lindner Timur Oezkan Daniel Zickler Wolfgang M. Kuebler Bernd Hamm Kai-Uwe Eckardt Frédéric Muench
author_facet	Markus H. Lerchbaumer Jonathan H. Lauryn Ulrike Bachmann Philipp Enghard Thomas Fischer Jana Grune Niklas Hegemann Dmytro Khadzhynov Jan Matthias Kruse Lukas J. Lehner Tobias Lindner Timur Oezkan Daniel Zickler Wolfgang M. Kuebler Bernd Hamm Kai-Uwe Eckardt Frédéric Muench
author_sort	Markus H. Lerchbaumer
title	Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study
title_short	Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study
title_full	Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study
title_fullStr	Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study
title_full_unstemmed	Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study
title_sort	point-of-care lung ultrasound in covid-19 patients: inter- and intra-observer agreement in a prospective observational study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/dee357e9df8041a7b493097d29fd7cbc
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Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study

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