dc.contributor.author |
Cullifod-Semmens, N |
en |
dc.contributor.author |
Nicholson, R |
en |
dc.contributor.author |
Tilton, E |
en |
dc.contributor.author |
Stirling, J |
en |
dc.contributor.author |
Sidhu, K |
en |
dc.contributor.author |
Webb, Rachel |
en |
dc.contributor.author |
Wilson, N |
en |
dc.date.accessioned |
2019-06-10T01:31:14Z |
en |
dc.date.issued |
2019-09-15 |
en |
dc.identifier.issn |
1874-1754 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/46881 |
en |
dc.description.abstract |
BACKGROUND:The World Heart Federation (WHF) criteria, published in 2012, provided an evidence-based guideline for the minimal diagnosis of echocardiographically-detected RHD. Primary aim of the study was to determine whether use of the WHF criteria altered the threshold for the diagnosis of echocardiographically-detected RHD compared with the previous WHO/NIH criteria. A secondary aim was to explore the utility of a three reviewer reporting system compared to a single or two reviewer reporting structure. METHODS:144 de-identified echocardiograms (RHD, congenital valvar abnormality, physiological valvar regurgitation) were independently reported using the WHF criteria by two reviewers blinded to the previous WHO/NIH diagnosis. If there was discordance between the two reviewers, a third cardiologist independently performed a tie-breaker review. RESULTS:There was a 21% reduction of cases classified as RHD using the WHF criteria compared to the modified WHO/NIH criteria (68 cases compared to 86, p = 0.04). There was a 60% consensus across the different diagnostic categories with 2 reviewers, 89% majority agreement with 3 reviewers. 11% required an open label discussion. There was moderate agreement between 2 reviewers for any RHD, kappa 0.57 (CI 0.44-0.70), with no significant difference in agreement between the different categories. CONCLUSION:The WHF criteria have raised the threshold for the diagnosis of RHD compared to the WHO/NIH criteria. However, inter-reporter variability of the WHF criteria is high. A three reviewer system is likely more accurate than a single or two reporter system for the diagnosis of mild RHD. This has resource implications for echocardiographic screening programmes. |
en |
dc.publisher |
Elsevier |
en |
dc.relation.ispartofseries |
International Journal of Cardiology |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.title |
The World Heart Federation criteria raise the threshold of diagnosis for mild rheumatic heart disease: Three reviewers are better than one |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1016/j.ijcard.2019.02.058 |
en |
pubs.begin-page |
112 |
en |
pubs.volume |
291 |
en |
dc.rights.holder |
Copyright: The author |
en |
pubs.end-page |
118 |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
766212 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Paediatrics Child & Youth Hlth |
en |
pubs.record-created-at-source-date |
2019-03-14 |
en |
pubs.online-publication-date |
2019-03-02 |
en |
pubs.dimensions-id |
30851993 |
en |