Evidence map›Paper›PMID 32027413›Full record

ArticleJournal of cardiac surgery2020

Critical appraisal of multidimensional CT measurements following acute open repair of type A aortic dissection.

Ignas B Houben, Theodorus M J van Bakel, Nicholas S Burris, Frans L Moll, Joost A van Herwaarden, Himanshu J Patel

Abstract read
In one paragraph

Article in Journal of cardiac surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ignas B HoubenDepartment of Cardiac Surgery, Frankel Cardiovascular Center, University of Michigan Health Center, Ann Arbor, Michigan.
Theodorus M J van BakelDepartment of Vascular Surgery, Frankel Cardiovascular Center, University of Michigan Health Center, Ann Arbor, Michigan.
Nicholas S BurrisDepartment of Radiology, University of Michigan Health Center, Ann Arbor, Michigan.
Frans L MollDepartment of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan, The Netherlands.
Joost A van HerwaardenDepartment of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan, The Netherlands.
Himanshu J PatelDepartment of Cardiac Surgery, Frankel Cardiovascular Center, University of Michigan Health Center, Ann Arbor, Michigan.

Funding

NHLBI NIH HHS L30 HL143671
6 · The paper itself

Abstract

introductionTo identify patients with aneurysmal degeneration of the native aorta following type A aortic dissection (TAAD), reproducible serial measurements of aortic dimensions are critical. We used a systematic workflow for measuring aortic geometry following TAAD, using computed tomography angiography data, and test its reproducibility.

methodsThe workflow for aortic measurements included centerline generation, luminal diameter, and area measurement at six anatomically defined locations along the aorta and luminal volumetric measurements in the descending aorta. Two independent observers measured the aortic geometry in 20 surgically repaired TAAD patients, preoperatively and at 3 months follow-up. To test reproducibility, intraobserver and interobserver agreement scores were analyzed using a concordance correlation coefficient (CCC).

resultsThe interobserver agreement scores of the diameter, area, and volumetric measurements in the descending aorta were acceptable. The agreement scores of the area measurements were highest, with CCCs ranging from 0.909 to 0.984. Luminal diameter measurements scored lower than luminal area measurements and were least reproducible at the mid aortic arch (CCC < 0.886). Overall, intraobserver agreement scores were better than interobserver agreement scores (SD of mean difference was 1.89 vs 1.94 for intraobserver vs interobserver diameter measurements, and 0.61 vs 0.66 for area measurements).

conclusionAlthough overall reproducibility was acceptable in descending aortic measurements, our results show that it remains challenging to reliably measure luminal diameters, compared with areas. To aid identification of early adverse remodeling following acute TAAD, novel two- and three-dimensional measurement techniques are needed that capture locoregional changes in the false lumen and true lumen morphology more accurately.

Indexed as

Acute DiseaseAortaAortic DissectionFollow-Up StudiesHumansReproducibility of ResultsTomography, X-Ray Computed3D imagingangiographic computed tomographydiameterfalse lumeninterrater agreementmorphologytype A dissection

Identifiers

PMID32027413
PMCPMC7079063

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