The intra- and inter-rater agreement of superior vena cava flow and right ventricular outflow measurements in late preterm and term infants

Mahoney, L., Fernandez-Alvarez, J.R., Rojas-Anaya, H., Aiton, N., Wertheim, D., Seddon, P. and Rabe, H. (2018) The intra- and inter-rater agreement of superior vena cava flow and right ventricular outflow measurements in late preterm and term infants. Journal of Ultrasound in Medicine, 37(9), pp. 2181-2190. ISSN (print) 0278-4297

Abstract

OBJECTIVES: To explore the intra- and inter-rater agreement of superior vena cava (SVC) flow and right ventricular (RV) outflow in healthy and unwell late preterm neonates (33-37 weeks' gestational age), term neonates (≥37 weeks' gestational age), and neonates receiving total-body cooling. METHODS: The intra- and inter-rater agreement (n = 25 and 41 neonates, respectively) rates for SVC flow and RV outflow were determined by echocardiography in healthy and unwell late preterm and term neonates with the use of Bland-Altman plots, the repeatability coefficient, the repeatability index, and intraclass correlation coefficients. RESULTS: The intra-rater repeatability index values were 41% for SVC flow and 31% for RV outflow, with intraclass correlation coefficients indicating good agreement for both measures. The inter-rater repeatability index values for SVC flow and RV outflow were 63% and 51%, respectively, with intraclass correlation coefficients indicating moderate agreement for both measures. CONCLUSIONS: If SVC flow or RV outflow is used in the hemodynamic treatment of neonates, sequential measurements should ideally be performed by the same clinician to reduce potential variability.

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