Impact of clinical training on supra-aortic duplex and transcranial doppler examination concordance

J Clin Ultrasound. 2016 Nov 12;44(9):571-579. doi: 10.1002/jcu.22379. Epub 2016 Aug 4.

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.

Keywords: accuracy; agreement; neurosonology; quality; training.

MeSH terms

  • Aorta / diagnostic imaging
  • Arterial Occlusive Diseases / diagnostic imaging*
  • Carotid Arteries / diagnostic imaging
  • Clinical Competence / statistics & numerical data*
  • Cohort Studies
  • Humans
  • Observer Variation
  • Prospective Studies
  • Reproducibility of Results
  • Ultrasonics / education*
  • Ultrasonography, Doppler, Duplex / statistics & numerical data*
  • Ultrasonography, Doppler, Transcranial / statistics & numerical data*
  • Vertebral Artery / diagnostic imaging