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J Perinatol. 2019 Feb;39(2):248-255. doi: 10.1038/s41372-018-0277-6. Epub 2018 Nov 21.

Agreement of an echocardiogram-based diagnosis of pulmonary hypertension in infants at risk for bronchopulmonary dysplasia among masked reviewers.

Author information

1
Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
2
Duke Clinical Research Institute, Durham, NC, USA.
3
Department of Pediatrics Center for Predictive Medicine, Duke University Medical Center, Durham, NC, USA.
4
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. matt_laughon@med.unc.edu.

Abstract

OBJECTIVE:

To evaluate the agreement of an echocardiogram-based pulmonary hypertension diagnosis in premature infants at risk for bronchopulmonary dysplasia (BPD).

STUDY DESIGN:

Echocardiograms from infants born ≤28 weeks post menstrual age were retrospectively reviewed with a standardized reading protocol by three pediatric cardiologists masked to patient's clinical history to determine the presence of pulmonary hypertension.

RESULTS:

A total of 483 echocardiograms from 49 unique patients were each reviewed by three pediatric cardiologists. Overall there was an 82.9% agreement on the presence of pulmonary hypertension among the three readers (95% CI: 78.4%, 85.4%) with a modified Fleiss' kappa of 0.759 (95% CI: 0.711, 0.801). Percent agreement between rereads was 92.4%, and modified Fleiss' kappa was 0.847 (95% CI: 0.750, 0.931).

CONCLUSIONS:

Using a standardized reading protocol and echocardiogram-based definition of pulmonary hypertension, there is high inter- and intra-rater agreement for the diagnosis of pulmonary hypertension in at-risk premature infants, suggesting echocardiography can be successfully used for clinical and research monitoring of pulmonary hypertension in infants.

PMID:
30464221
PMCID:
PMC6724723
[Available on 2020-02-01]
DOI:
10.1038/s41372-018-0277-6

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