Association Between Echocardiography Laboratory Accreditation and the Quality of Imaging and Reporting for Valvular Heart Disease

Jeremy J. Thaden, Michael Y. Tsang, Chadi Ayoub, Ratnasari Padang, Vuyisile T Nkomo, Stephen F. Tucker, Cynthia S. Cassidy, Merri Bremer, Garvan M Kane, Patricia Pellikka

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND: It is presumed that echocardiographic laboratory accreditation leads to improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited versus nonaccredited laboratories for the evaluation of valvular heart disease.

METHODS AND RESULTS: We enrolled 335 consecutive valvular heart disease subjects who underwent echocardiography at our institution and an external accredited or nonaccredited institution within 6 months. Completeness and quality of echocardiographic reports and images were assessed by investigators blinded to the external laboratory accreditation status and echocardiographic results. Compared with nonaccredited laboratories, accredited sites more frequently reported patient sex (94% versus 78%; P<0.001), height and weight (96% versus 63%; P<0.001), blood pressure (86% versus 39%; P<0.001), left ventricular size (96% versus 83%; P<0.001), right ventricular size (94% versus 80%; P=0.001), and right ventricular function (87% versus 73%; P=0.006). Accredited laboratories had higher rates of complete and diagnostic color (58% versus 35%; P=0.002) and spectral Doppler imaging (45% versus 21%; P<0.0001). Concordance between external and internal grading of external studies was improved when diagnostic quantification was performed (85% versus 69%; P=0.003), and in patients with mitral regurgitation, reproducibility was improved with higher quality color Doppler imaging.

CONCLUSIONS: Accredited echocardiographic laboratories had more complete reporting and better image quality, while echocardiographic quantification and color Doppler image quality were associated with improved concordance in grading valvular heart disease. Future quality improvement initiatives should highlight the importance of high-quality color Doppler imaging and echocardiographic quantification to improve the accuracy, reproducibility, and quality of echocardiographic studies for valvular heart disease.

Original languageEnglish (US)
JournalCirculation. Cardiovascular imaging
Volume10
Issue number8
DOIs
StatePublished - Aug 1 2017

Fingerprint

Heart Valve Diseases
Accreditation
Echocardiography
Color
Right Ventricular Function
Mitral Valve Insufficiency
Quality Improvement
Research Personnel
Blood Pressure
Weights and Measures

Keywords

  • accreditation
  • echocardiography
  • quality
  • valvular heart disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Association Between Echocardiography Laboratory Accreditation and the Quality of Imaging and Reporting for Valvular Heart Disease. / Thaden, Jeremy J.; Tsang, Michael Y.; Ayoub, Chadi; Padang, Ratnasari; Nkomo, Vuyisile T; Tucker, Stephen F.; Cassidy, Cynthia S.; Bremer, Merri; Kane, Garvan M; Pellikka, Patricia.

In: Circulation. Cardiovascular imaging, Vol. 10, No. 8, 01.08.2017.

Research output: Contribution to journalArticle

Thaden, Jeremy J. ; Tsang, Michael Y. ; Ayoub, Chadi ; Padang, Ratnasari ; Nkomo, Vuyisile T ; Tucker, Stephen F. ; Cassidy, Cynthia S. ; Bremer, Merri ; Kane, Garvan M ; Pellikka, Patricia. / Association Between Echocardiography Laboratory Accreditation and the Quality of Imaging and Reporting for Valvular Heart Disease. In: Circulation. Cardiovascular imaging. 2017 ; Vol. 10, No. 8.
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abstract = "BACKGROUND: It is presumed that echocardiographic laboratory accreditation leads to improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited versus nonaccredited laboratories for the evaluation of valvular heart disease.METHODS AND RESULTS: We enrolled 335 consecutive valvular heart disease subjects who underwent echocardiography at our institution and an external accredited or nonaccredited institution within 6 months. Completeness and quality of echocardiographic reports and images were assessed by investigators blinded to the external laboratory accreditation status and echocardiographic results. Compared with nonaccredited laboratories, accredited sites more frequently reported patient sex (94{\%} versus 78{\%}; P<0.001), height and weight (96{\%} versus 63{\%}; P<0.001), blood pressure (86{\%} versus 39{\%}; P<0.001), left ventricular size (96{\%} versus 83{\%}; P<0.001), right ventricular size (94{\%} versus 80{\%}; P=0.001), and right ventricular function (87{\%} versus 73{\%}; P=0.006). Accredited laboratories had higher rates of complete and diagnostic color (58{\%} versus 35{\%}; P=0.002) and spectral Doppler imaging (45{\%} versus 21{\%}; P<0.0001). Concordance between external and internal grading of external studies was improved when diagnostic quantification was performed (85{\%} versus 69{\%}; P=0.003), and in patients with mitral regurgitation, reproducibility was improved with higher quality color Doppler imaging.CONCLUSIONS: Accredited echocardiographic laboratories had more complete reporting and better image quality, while echocardiographic quantification and color Doppler image quality were associated with improved concordance in grading valvular heart disease. Future quality improvement initiatives should highlight the importance of high-quality color Doppler imaging and echocardiographic quantification to improve the accuracy, reproducibility, and quality of echocardiographic studies for valvular heart disease.",
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AU - Padang, Ratnasari

AU - Nkomo, Vuyisile T

AU - Tucker, Stephen F.

AU - Cassidy, Cynthia S.

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N2 - BACKGROUND: It is presumed that echocardiographic laboratory accreditation leads to improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited versus nonaccredited laboratories for the evaluation of valvular heart disease.METHODS AND RESULTS: We enrolled 335 consecutive valvular heart disease subjects who underwent echocardiography at our institution and an external accredited or nonaccredited institution within 6 months. Completeness and quality of echocardiographic reports and images were assessed by investigators blinded to the external laboratory accreditation status and echocardiographic results. Compared with nonaccredited laboratories, accredited sites more frequently reported patient sex (94% versus 78%; P<0.001), height and weight (96% versus 63%; P<0.001), blood pressure (86% versus 39%; P<0.001), left ventricular size (96% versus 83%; P<0.001), right ventricular size (94% versus 80%; P=0.001), and right ventricular function (87% versus 73%; P=0.006). Accredited laboratories had higher rates of complete and diagnostic color (58% versus 35%; P=0.002) and spectral Doppler imaging (45% versus 21%; P<0.0001). Concordance between external and internal grading of external studies was improved when diagnostic quantification was performed (85% versus 69%; P=0.003), and in patients with mitral regurgitation, reproducibility was improved with higher quality color Doppler imaging.CONCLUSIONS: Accredited echocardiographic laboratories had more complete reporting and better image quality, while echocardiographic quantification and color Doppler image quality were associated with improved concordance in grading valvular heart disease. Future quality improvement initiatives should highlight the importance of high-quality color Doppler imaging and echocardiographic quantification to improve the accuracy, reproducibility, and quality of echocardiographic studies for valvular heart disease.

AB - BACKGROUND: It is presumed that echocardiographic laboratory accreditation leads to improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited versus nonaccredited laboratories for the evaluation of valvular heart disease.METHODS AND RESULTS: We enrolled 335 consecutive valvular heart disease subjects who underwent echocardiography at our institution and an external accredited or nonaccredited institution within 6 months. Completeness and quality of echocardiographic reports and images were assessed by investigators blinded to the external laboratory accreditation status and echocardiographic results. Compared with nonaccredited laboratories, accredited sites more frequently reported patient sex (94% versus 78%; P<0.001), height and weight (96% versus 63%; P<0.001), blood pressure (86% versus 39%; P<0.001), left ventricular size (96% versus 83%; P<0.001), right ventricular size (94% versus 80%; P=0.001), and right ventricular function (87% versus 73%; P=0.006). Accredited laboratories had higher rates of complete and diagnostic color (58% versus 35%; P=0.002) and spectral Doppler imaging (45% versus 21%; P<0.0001). Concordance between external and internal grading of external studies was improved when diagnostic quantification was performed (85% versus 69%; P=0.003), and in patients with mitral regurgitation, reproducibility was improved with higher quality color Doppler imaging.CONCLUSIONS: Accredited echocardiographic laboratories had more complete reporting and better image quality, while echocardiographic quantification and color Doppler image quality were associated with improved concordance in grading valvular heart disease. Future quality improvement initiatives should highlight the importance of high-quality color Doppler imaging and echocardiographic quantification to improve the accuracy, reproducibility, and quality of echocardiographic studies for valvular heart disease.

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