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Point-of-care lung ultrasound in COVID-19 patients: inter- and intra-observer agreement in a prospective observational study.
Lerchbaumer, Markus H; Lauryn, Jonathan H; Bachmann, Ulrike; Enghard, Philipp; Fischer, Thomas; Grune, Jana; Hegemann, Niklas; Khadzhynov, Dmytro; Kruse, Jan Matthias; Lehner, Lukas J; Lindner, Tobias; Oezkan, Timur; Zickler, Daniel; Kuebler, Wolfgang M; Hamm, Bernd; Eckardt, Kai-Uwe; Muench, Frédéric.
  • Lerchbaumer MH; Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany.
  • Lauryn JH; Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany.
  • Bachmann U; German Center for Cardiovascular Research (DZHK), Partner Site, Berlin, Germany.
  • Enghard P; Department of Emergency Medicine (CVK, CCM), Charité - Universitätsmedizin, Berlin, Germany.
  • Fischer T; Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
  • Grune J; Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany.
  • Hegemann N; Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany.
  • Khadzhynov D; German Center for Cardiovascular Research (DZHK), Partner Site, Berlin, Germany.
  • Kruse JM; Center for Systems Biology, Massachusetts General Hospital Research Institute, Harvard Medical School, Boston, USA.
  • Lehner LJ; Institute of Physiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany.
  • Lindner T; German Center for Cardiovascular Research (DZHK), Partner Site, Berlin, Germany.
  • Oezkan T; Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
  • Zickler D; Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
  • Kuebler WM; Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
  • Hamm B; Department of Emergency Medicine (CVK, CCM), Charité - Universitätsmedizin, Berlin, Germany.
  • Eckardt KU; Department of Emergency Medicine (CVK, CCM), Charité - Universitätsmedizin, Berlin, Germany.
  • Muench F; Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Sci Rep ; 11(1): 10678, 2021 05 21.
Article in English | MEDLINE | ID: covidwho-1238016
Semantic information from SemMedBD (by NLM)
1. Lung LOCATION_OF Point of care ultrasound
Subject
Lung
Predicate
LOCATION_OF
Object
Point of care ultrasound
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Lung LOCATION_OF Ultrasonography
Subject
Lung
Predicate
LOCATION_OF
Object
Ultrasonography
4. loops TREATS Patients
Subject
loops
Predicate
TREATS
Object
Patients
5. Toxic Epidermal Necrolysis PROCESS_OF Observer
Subject
Toxic Epidermal Necrolysis
Predicate
PROCESS_OF
Object
Observer
6. loops USES Too
Subject
loops
Predicate
USES
Object
Too
7. Contrast bronchogram USES air
Subject
Contrast bronchogram
Predicate
USES
Object
air
8. Ultrasonography ADMINISTERED_TO Research Personnel
Subject
Ultrasonography
Predicate
ADMINISTERED_TO
Object
Research Personnel
9. Lung LOCATION_OF Point of care ultrasound
Subject
Lung
Predicate
LOCATION_OF
Object
Point of care ultrasound
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Lung LOCATION_OF Ultrasonography
Subject
Lung
Predicate
LOCATION_OF
Object
Ultrasonography
12. loops TREATS Patients
Subject
loops
Predicate
TREATS
Object
Patients
13. Toxic Epidermal Necrolysis PROCESS_OF Observer
Subject
Toxic Epidermal Necrolysis
Predicate
PROCESS_OF
Object
Observer
14. loops USES Tool, device (physical object)
Subject
loops
Predicate
USES
Object
Tool, device (physical object)
15. Contrast bronchogram USES air
Subject
Contrast bronchogram
Predicate
USES
Object
air
16. Ultrasonography ADMINISTERED_TO Research Personnel
Subject
Ultrasonography
Predicate
ADMINISTERED_TO
Object
Research Personnel
ABSTRACT
With an urgent need for bedside imaging of coronavirus disease 2019 (COVID-19), this study's main goal was to assess inter- and intraobserver agreement in lung ultrasound (LUS) of COVID-19 patients. In this single-center study we prospectively acquired and evaluated 100 recorded ten-second cine-loops in confirmed COVID-19 intensive care unit (ICU) patients. All loops were rated by ten observers with different subspeciality backgrounds for four times by each observer (400 loops overall) in a random sequence using a web-based rating tool. We analyzed inter- and intraobserver variability for specific pathologies and a semiquantitative LUS score. Interobserver agreement for both, identification of specific pathologies and assignment of LUS scores was fair to moderate (e.g., LUS score 1 Fleiss' κ = 0.27; subpleural consolidations Fleiss' κ = 0.59). Intraobserver agreement was mostly moderate to substantial with generally higher agreement for more distinct findings (e.g., lowest LUS score 0 vs. highest LUS score 3 (median Fleiss' κ = 0.71 vs. 0.79) or air bronchograms (median Fleiss' κ = 0.72)). Intraobserver consistency was relatively low for intermediate LUS scores (e.g. LUS Score 1 median Fleiss' κ = 0.52). We therefore conclude that more distinct LUS findings (e.g., air bronchograms, subpleural consolidations) may be more suitable for disease monitoring, especially with more than one investigator and that training material used for LUS in point-of-care ultrasound (POCUS) should pay refined attention to areas such as B-line quantification and differentiation of intermediate LUS scores.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Point-of-Care Systems / SARS-CoV-2 / COVID-19 / Lung Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male / Middle aged Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-90153-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Point-of-Care Systems / SARS-CoV-2 / COVID-19 / Lung Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Limits: Female / Humans / Male / Middle aged Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-90153-2