2 research outputs found
Spectrum of KV2.1 Dysfunction in KCNB1âAssociated Neurodevelopmental Disorders
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152486/1/ana25607.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152486/2/ana25607_am.pd
What are the minimum requirements to establish proficiency in lung ultrasound training for quantifying B-lines?
Aims
The goal of this study was to determine the number of scans needed for novice learners to attain proficiency in Bâline quantification compared with expert interpretation.
Methods and results
This was a prospective, multicentre observational study of novice learners, physicians and nonâphysicians from three academic institutions. Learners received a 2 h lung ultrasound (LUS) training session on Bâline assessment, including lecture, video review to practice counting and handsâon patient scanning. Learners quantified Bâlines using an eightâzone scanning protocol in patients with suspected acute heart failure. Ultrasound (US) machine settings were standardized to a depth of 18 cm and clip length of 6 s, and tissue harmonics and multibeam former were deactivated. For quantification, the intercostal space with the greatest number of Bâlines within each zone was used for scoring. Each zone was given a score of 0â20 based on the maximum number of Bâlines counted during one respiratory cycle. The Bâline score was determined by multiplying the percentage of the intercostal space filled with Bâlines by 20. We compared learner Bâline counts with a blinded expert reviewer (five US fellowshipâtrained faculty with > 5 years of clinical experience) for each lung zone scanned; proficiency was defined as an intraclass correlation of > 0.7. Learning curves for each learner were constructed using cumulative sum method for statistical analysis. The Wilcoxon rankâsum test was used to compare the number of scans required to reach proficiency between different learner types.
Twentyânine learners (21 research associates, 5 residents and 3 nonâUSâtrained emergency medicine faculty) scanned 2629 lung zones with acute pulmonary oedema. After a mean of 10.8 (standard deviation 14.0) LUS zones scanned, learners reached the predefined proficiency standard. The number of scanned zones required to reach proficiency was not significantly different between physicians and nonâphysicians (P = 0.26), learners with no prior US experience vs. > 25 prior patient scans (P = 0.64) and no prior vs. some prior LUS experience (P = 0.59). The overall intraclass correlation for agreement between learners and experts was 0.74 and 0.80 between experts.
Conclusions
Our results show that after a short, structured training, novice learners are able to achieve proficiency for quantifying Bâlines on LUS after scanning 11 zones. These findings support the use of LUS for Bâline quantification by nonâphysicians in clinical and research applications