Evidence map›Paper›PMID 34384239›Full record

ArticleCirculation. Cardiovascular imaging2021

Single-View Echocardiography by Nonexpert Practitioners to Detect Rheumatic Heart Disease: A Prospective Study of Diagnostic Accuracy.

Joshua R Francis, Gillian A Whalley, Alex Kaethner, Helen Fairhurst, Hilary Hardefeldt, Benjamin Reeves, Benjamin Auld, James Marangou, Ari Horton, Gavin Wheaton and 25 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
4.5field-weighted citation impact, top 5% of its field
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

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

35 authors at 13 institutions in 5 countries.

Joshua R FrancisGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Australia (J.R.F., H.F., J.M., J.Y., A.P.R., B.R.).
Gillian A WhalleyDunedin School of Medicine, University of Otago, New Zealand (G.A.W.).
Alex KaethnerNT Cardiac, Australia (A.K., J.M., B.R.).
Helen FairhurstGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Australia (J.R.F., H.F., J.M., J.Y., A.P.R., B.R.).
Hilary HardefeldtDepartment of Pediatrics, Royal Darwin Hospital, Australia (J.R.F., H.H., A.H., L.A.F., K.D., J.Y., K.V.R., B.R.).
Benjamin Reeves
Benjamin AuldDepartment of Cardiology, Queensland Children's Hospital, Australia (B.A.).
James MarangouGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Australia (J.R.F., H.F., J.M., J.Y., A.P.R., B.R.).
Ari HortonDepartment of Pediatrics, Royal Darwin Hospital, Australia (J.R.F., H.H., A.H., L.A.F., K.D., J.Y., K.V.R., B.R.).
Gavin WheatonDepartment of Cardiology, Women's and Children's Hospital, Australia (G.W., T.R.).
Terry RobertsonDepartment of Cardiology, Women's and Children's Hospital, Australia (G.W., T.R.).
Chelsea RyanManingrida Health Center (C.R., S.B., G.S.), Top End Health Services, Australia.
Shannon BrownManingrida Health Center (C.R., S.B., G.S.), Top End Health Services, Australia.
Greg SmithManingrida Health Center (C.R., S.B., G.S.), Top End Health Services, Australia.
Januario Dos SantosMaluk Timor, Timor-Leste (J.R.F., J.D.S., R.F., K.E.).
Ricardo FlavioMaluk Timor, Timor-Leste (J.R.F., J.D.S., R.F., K.E.).
Karolina EmbaumMaluk Timor, Timor-Leste (J.R.F., J.D.S., R.F., K.E.).
Mario da Graca NoronhaDepartment of Pediatrics, Hospital Nacional Guido Valadares, Timor-Leste (M.d.G.N., S.L.B., C.M.S., M.G.d.S., J.C., I.d.R., I.d.S.A.).
Sonia Lopes BeloDepartment of Pediatrics, Hospital Nacional Guido Valadares, Timor-Leste (M.d.G.N., S.L.B., C.M.S., M.G.d.S., J.C., I.d.R., I.d.S.A.).
Carla Madeira SantosDepartment of Pediatrics, Hospital Nacional Guido Valadares, Timor-Leste (M.d.G.N., S.L.B., C.M.S., M.G.d.S., J.C., I.d.R., I.d.S.A.).
Maria Georginha Dos SantosDepartment of Pediatrics, Hospital Nacional Guido Valadares, Timor-Leste (M.d.G.N., S.L.B., C.M.S., M.G.d.S., J.C., I.d.R., I.d.S.A.).
Jose CabralDepartment of Pediatrics, Hospital Nacional Guido Valadares, Timor-Leste (M.d.G.N., S.L.B., C.M.S., M.G.d.S., J.C., I.d.R., I.d.S.A.).
Ivonia do RosarioDepartment of Pediatrics, Hospital Nacional Guido Valadares, Timor-Leste (M.d.G.N., S.L.B., C.M.S., M.G.d.S., J.C., I.d.R., I.d.S.A.).
Jessica Harries
Laura A FrancisDepartment of Pediatrics, Royal Darwin Hospital, Australia (J.R.F., H.H., A.H., L.A.F., K.D., J.Y., K.V.R., B.R.).
Anthony D K DraperCenter for Disease Control (L.A.F., A.D.K.D., C.L.J.), Top End Health Services, Australia.
Christian L JamesCenter for Disease Control (L.A.F., A.D.K.D., C.L.J.), Top End Health Services, Australia.
Kimberly DavisDepartment of Pediatrics, Royal Darwin Hospital, Australia (J.R.F., H.H., A.H., L.A.F., K.D., J.Y., K.V.R., B.R.).
Jennifer YanGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Australia (J.R.F., H.F., J.M., J.Y., A.P.R., B.R.).
Alice Mitchell
Ines da Silva AlmeidaDepartment of Pediatrics, Hospital Nacional Guido Valadares, Timor-Leste (M.d.G.N., S.L.B., C.M.S., M.G.d.S., J.C., I.d.R., I.d.S.A.).
Daniel EngelmanTropical Diseases, Murdoch Children's Research Institute, Australia (D.E.).
Kathryn V RobertsDepartment of Pediatrics, Royal Darwin Hospital, Australia (J.R.F., H.H., A.H., L.A.F., K.D., J.Y., K.V.R., B.R.).
Anna P RalphGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Australia (J.R.F., H.F., J.M., J.Y., A.P.R., B.R.).
Bo RemenyiGlobal and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Australia (J.R.F., H.F., J.M., J.Y., A.P.R., B.R.).
United States Nuclear Regulatory Commission · USCharles Darwin University · AURoyal Darwin Hospital · AUDepartment of Health and Human Services · AUDepartment of Health Services · NPNational University of East Timor · TLSan Diego Cardiac Center · USWomen's and Children's Hospital · AUCairns Hospital · AUChildren's Health Queensland Hospital and Health Service · AUMenzies School of Health Research · AUMurdoch Children's Research Institute · AUUniversity of Otago · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEchocardiographic screening can detect asymptomatic cases of rheumatic heart disease (RHD), facilitating access to treatment. Barriers to implementation of echocardiographic screening include the requirement for expensive equipment and expert practitioners. We aimed to evaluate the diagnostic accuracy of an abbreviated echocardiographic screening protocol (single parasternal-long-axis view with a sweep of the heart) performed by briefly trained, nonexpert practitioners using handheld ultrasound devices.

methodsParticipants aged 5 to 20 years in Timor-Leste and the Northern Territory of Australia had 2 echocardiograms: one performed by an expert echocardiographer using a GE Vivid I or Vivid Q portable ultrasound device (reference test), and one performed by a nonexpert practitioner using a GE Vscan handheld ultrasound device (index test). The accuracy of the index test, compared with the reference test, for identifying cases with definite or borderline RHD was determined.

resultsThere were 3111 enrolled participants; 2573 had both an index test and reference test. Median age was 12 years (interquartile range, 10-15); 58.2% were female. Proportion with definite or borderline RHD was 5.52% (95% CI, 4.70-6.47); proportion with definite RHD was 3.23% (95% CI, 2.61-3.98). Compared with the reference test, sensitivity of the index test for definite or borderline RHD was 70.4% (95% CI, 62.2-77.8), specificity was 78.1% (95% CI, 76.4-79.8).

conclusionsNonexpert practitioners can be trained to perform single parasternal-long-axis view with a sweep of the heart echocardiography. However, the specificity and sensitivity are inadequate for echocardiographic screening. Improved training for nonexpert practitioners should be investigated.

Indexed as

Clinical CompetenceEchocardiography, Doppler, ColorInservice TrainingAdolescentChildChild, PreschoolCross-Sectional StudiesEducation, Medical, ContinuingEducation, Nursing, ContinuingFemaleHumansMaleNew ZealandNorthern TerritoryPredictive Value of TestsProspective Studiesechocardiographyrheumatic heart diseasescreening

Identifiers

PMID34384239
PMCPMC8373443
OpenAlexW3188818545

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.