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- Title
Efficacy of a remote web-based lung ultrasound training for nephrologists and cardiologists: a LUST trial sub-project.
- Authors
Gargani, Luna; Sicari, Rosa; Raciti, Mauro; Serasini, Luca; Passera, Mirko; Torino, Claudia; Letachowicz, Krzysztof; Ekart, Robert; Fliser, Danilo; Covic, Adrian; Balafa, Olga; Stavroulopoulos, Aristeidis; Massy, Ziad A.; Fiaccadori, Enrico; Caiazza, Alberto; Bachelet, Thomas; Slotki, Itzchak; Shavit, Linda; Martinez-Castelao, Alberto; Coudert-Krier, Marie-Jeanne
- Abstract
Within the framework of the LUST trial (LUng water by Ultra-Sound guided Treatment to prevent death and cardiovascular events in high-risk end-stage renal disease patients), the European Renal and Cardiovascular Medicine (EURECAm) working group of the European Renal Association-European Dialysis Transplant Association established a central core lab aimed at training and certifying nephrologists and cardiologists participating in this trial. All participants were trained by an expert trainer with an entirely webbased programme. Thirty nephrologists and 14 cardiologists successfully completed the training. At the end of training, a set of 47 lung ultrasound (US) videos was provided to trainees who were asked to estimate the number of B-lines in each video. The intraclass correlation coefficient (ICC) for the whole series of 47 videos between each trainee and the expert trainer was high (average 0.81 ± 0.21) and >0.70 in all but five cases. After further training, the five underperforming trainees achieved satisfactory agreement with the expert trainer (average post-retraining ICC 0.74 ± 0.14). The Bland-Altman plot showed virtually no bias (difference between the mean 0.03) and strict 95% limits of agreement lines (-1.52 and 1.45 US B-lines). Only four cases overlapped but did not exceed the same limits. Likewise, the Spearman correlation coefficient applied to the same data series was very high (r = 0.979, P < 0.0001). Nephrologists and cardiologists can be effectively trained to measure lung congestion by an entirely web-based programme. This web-based training programme ensures high-quality standardization of US B-line measurements and represents a simple, costless and effective preparatory step for clinical trials targeting lung congestion.
- Subjects
LUNG radiography; CARDIOVASCULAR disease prevention; HEMODIALYSIS; LUNG congestion; CARDIOLOGISTS
- Publication
Nephrology Dialysis Transplantation, 2016, Vol 31, Issue 12, p1982
- ISSN
0931-0509
- Publication type
Article
- DOI
10.1093/ndt/gfw329