Observational studyEchocardiography (Mount Kisco, N.Y.)2019
Accuracy and reliability of qualitative echocardiography assessment of right ventricular size and function in neonates.
Observational study in Echocardiography (Mount Kisco, N.Y.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 42 citations in OpenAlex.
- A hemodynamic-driven approach to chronic pulmonary hypertension in congenital diaphragmatic hernia.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Hemodynamics in infants with hypoxemic ischemic encephalopathy: pathophysiology and beyond.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Neonatal sepsis and cardiovascular dysfunction II: assessment.Pediatric research · 2026Review
- Stealing nephrons-a review on how patent ductus arteriosus physiology impacts neonatal kidney health.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- [Selective interpretation of the "Guidelines and recommendations for targeted neonatal echocardiography and cardiac point-of-care ultrasound in the neonatal intensive care unit: an update from the American Society of Echocardiography"].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Article
- Hemodynamic precision to guide surgical timing for neonates with congenital diaphragmatic hernia: a narrative review.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Impact of the transpulmonary pressure on right ventricle impairment incidence during acute respiratory distress syndrome: a pilot study in adults and children.Intensive care medicine experimental · 2024Article
- Growth of targeted neonatal echocardiography in Chinese neonatal intensive care units: gaps in practice and training.European journal of pediatrics · 2023Article
- Article
- Hemodynamic consequences of respiratory interventions in preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2022Review
- The association between pulmonary vascular disease and respiratory improvement in infants with type I severe bronchopulmonary dysplasia.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Right Ventricular Volumes, Ejection Fraction, and Systolic Function Indices in Normal Neonates by Three-Dimensional Speckle-Tracking Echocardiography.Pediatric cardiology · 2022Article
- Care of the critically ill neonate with hypoxemic respiratory failure and acute pulmonary hypertension: framework for practice based on consensus opinion of neonatal hemodynamics working group.Journal of perinatology : official journal of the California Perinatal Association · 2022Review
- 3D modeling and printing for complex biventricular repair of double outlet right ventricle.Frontiers in cardiovascular medicine · 2022Article
- Tripartite Assessment of Right Ventricular Systolic Function in Persistent Pulmonary Hypertension of the Newborn.Pediatric cardiology · 2020Article
- Quality Improvement Methodology Facilitates Adherence to Echocardiogram Protocol Measurements.Pediatric quality & safetyArticle
Corrections and comments
- Commented on by
- Commented on by
- Erratum issuedCorrigendum.2019
Authors and funding
10 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundSubjective assessment of right ventricular (RV) function by neonatal echocardiography lacks validation. Incorrect diagnostic assignment in patients with suspected pulmonary hypertension (PH) may lead to unnecessary treatment or missed treatment opportunities.
methodsSix evaluators (experts [n = 3], novice [n = 3]) were asked to independently rate RV characteristics (global function, dilation, and septal flattening) based on standardized echocardiography images. We randomly selected 60 infants, ≥35 weeks gestation at birth, of whom 30 were clinically unwell with acute pulmonary hypertension (aPH) and 30 were healthy controls. aPH was defined by echocardiography presence of right-left shunting across transitional shunts or elevated right ventricular systolic pressure as estimated by the magnitude of the regurgitant jet across the tricuspid valve with impaired oxygenation. Inter-rater comparative evaluation within groups and between groups was performed using Kappa statistics.
resultsGlobal agreement between evaluators for subjective assessment of RV function (0.3 [0.03], P < 0.001), size (0.14 [0.02], P < 0.001), and septal flattening (0.2 [0.02], P < 0.001) was uniformly poor. Agreement in RV function assessment was marginally better for both expert (0.32 [0.08], P < 0.001 vs 0.13 [0.081], and P < 0.001) and novice (0.4 [0.08], P < 0.001 vs 0.06 [0.07], and P < 0.001) evaluators. Overall, the diagnosis of aPH vs control was misclassified in 18% of cases.
conclusionThis study demonstrated significant variability in qualitative assessment of RV size and function by trained evaluators, regardless of level of expertise attained. The reliability of objective measures of RV hemodynamics requires prospective evaluation.
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