ArticleIntensive care medicine experimental2021
Evaluation of automated microvascular flow analysis software AVA 4: a validation study.
Article in Intensive care medicine experimental, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 16 citations in OpenAlex.
- The OxyCam: A novel hand-held vital microscope for quantitative measurement of microcirculatory perfusion and oxygenation.Journal of intensive medicine · 2026Article
- Effects of fluids on sublingual microcirculation: a point of view review.Annals of intensive care · 2025Review
- Biomarkers of Microcirculatory Dysfunction in Sepsis: A Pilot Prospective Observational Study.Critical care explorations · 2025Observational
- Interobserver reliability for manual analysis of sidestream darkfield videomicroscopy clips after resizing in ImageJ.Intensive care medicine experimental · 2023Article
- The sublingual microcirculation and frailty index in chronic kidney disease patients.Microcirculation (New York, N.Y. : 1994) · 2023Article
- Microcirculation-guided resuscitation in sepsis: the next frontier?Frontiers in medicine · 2023Review
- Local Mucosal COFrontiers in medicine · 2022Article
- Microcirculation during surgery.Anesthesia and pain medicine · 2022Review
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReal-time automated analysis of videos of the microvasculature is an essential step in the development of research protocols and clinical algorithms that incorporate point-of-care microvascular analysis. In response to the call for validation studies of available automated analysis software by the European Society of Intensive Care Medicine, and building on a previous validation study in sheep, we report the first human validation study of AVA 4.
methodsTwo retrospective perioperative datasets of human microcirculation videos (P1 and P2) and one prospective healthy volunteer dataset (V1) were used in this validation study. Video quality was assessed using the modified Microcirculation Image Quality Selection (MIQS) score. Videos were initially analyzed with (1) AVA software 3.2 by two experienced investigators using the gold standard semi-automated method, followed by an analysis with (2) AVA automated software 4.1. Microvascular variables measured were perfused vessel density (PVD), total vessel density (TVD), and proportion of perfused vessels (PPV). Bland-Altman analysis and intraclass correlation coefficients (ICC) were used to measure agreement between the two methods. Each method's ability to discriminate between microcirculatory states before and after induction of general anesthesia was assessed using paired t-tests.
resultsFifty-two videos from P1, 128 videos from P2 and 26 videos from V1 met inclusion criteria for analysis. Correlational analysis and Bland-Altman analysis revealed poor agreement and no correlation between AVA 4.1 and AVA 3.2. Following the induction of general anesthesia, TVD and PVD measured using AVA 3.2 increased significantly for P1 (p < 0.05) and P2 (p < 0.05). However, these changes could not be replicated with the data generated by AVA 4.1.
conclusionsAVA 4.1 is not a suitable tool for research or clinical purposes at this time. Future validation studies of automated microvascular flow analysis software should aim to measure the new software's agreement with the gold standard, its ability to discriminate between clinical states and the quality thresholds at which its performance becomes unacceptable.
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