Clinical agreement between nurses in the ultrasound measurement of abdominal aortic diameter within a national screening programme

Michael A Crilly, Alison Mundie, Paul Bachoo, Penny Bruce, Fiona A Colvin, Wendy A Geddes, Hazel E Smart

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Accurate measurement is central to AAA-screening, but information concerning differences between-observers using modern ultrasound devices is lacking. Our aim was to assess clinical agreement among nurses within a national screening programme.

MATERIAL AND METHODS: Between-observer repeatability was assessed among two pairs of nurses (A&B; C&D) screening a consecutive series of men at a single community-clinic in Grampian, Scotland. All four nurses used the same ultrasound device (GE-LOGIQe 1.5-4.6 MHz curvilinear probe) to measure maximal infrarenal inner-to-inner (ITI) anteroposterior diameter in longitudinal and transverse planes. Nurses alternated in their measurements and were blinded to their partners' measurements. Participants remained supine whilst 'double-scanned'. Clinical agreement was assessed as twice the standard deviation (2SD) of mean differences. Analysis was undertaken using IBM-SPSS-Statistics (version 22) using the Bland-Altman 'limits of agreement' (95% LoA) approach (mean difference ±2SD) and related plots.

RESULTS: A total of 63 consecutive men underwent assessment (30 men by nurses A&B; 33 men by nurses C&D). Mean age 65.5 years, brachial BP 145/88 mmHg, current smokers 14%, never smoked 41%, diabetic 18%, arterial disease 11%, daily aspirin 16%, anti-hypertensives 35% and statin therapy 44%. Mean aortic diameter (ITI) was 1.81 cms (range 1.28 to 2.45; SD 0.18). Pooled mean differences between-nurses was 0.05 cms (95% CI 0.02 to 0.08); 2SD ±0.23 with 95% LOA -0.18 to 0.28 cms. Repeatability was similar in both planes and for both pairs of nurses.

CONCLUSION: Nurses can achieve a high level of agreement in the measurement of aortic diameter in a routine clinical setting.

Original languageEnglish
Pages (from-to)194-201
Number of pages8
JournalAnnals of Vascular Surgery
Volume33
Early online date21 Feb 2016
DOIs
Publication statusPublished - May 2016

Fingerprint

Nurses
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Equipment and Supplies
Scotland
Antihypertensive Agents
Aspirin
Arm

Cite this

Clinical agreement between nurses in the ultrasound measurement of abdominal aortic diameter within a national screening programme. / Crilly, Michael A; Mundie, Alison; Bachoo, Paul; Bruce, Penny; Colvin, Fiona A; Geddes, Wendy A; Smart, Hazel E.

In: Annals of Vascular Surgery, Vol. 33, 05.2016, p. 194-201.

Research output: Contribution to journalArticle

@article{b4760e12f60945feae241ede6399a292,
title = "Clinical agreement between nurses in the ultrasound measurement of abdominal aortic diameter within a national screening programme",
abstract = "BACKGROUND: Accurate measurement is central to AAA-screening, but information concerning differences between-observers using modern ultrasound devices is lacking. Our aim was to assess clinical agreement among nurses within a national screening programme.MATERIAL AND METHODS: Between-observer repeatability was assessed among two pairs of nurses (A&B; C&D) screening a consecutive series of men at a single community-clinic in Grampian, Scotland. All four nurses used the same ultrasound device (GE-LOGIQe 1.5-4.6 MHz curvilinear probe) to measure maximal infrarenal inner-to-inner (ITI) anteroposterior diameter in longitudinal and transverse planes. Nurses alternated in their measurements and were blinded to their partners' measurements. Participants remained supine whilst 'double-scanned'. Clinical agreement was assessed as twice the standard deviation (2SD) of mean differences. Analysis was undertaken using IBM-SPSS-Statistics (version 22) using the Bland-Altman 'limits of agreement' (95{\%} LoA) approach (mean difference ±2SD) and related plots.RESULTS: A total of 63 consecutive men underwent assessment (30 men by nurses A&B; 33 men by nurses C&D). Mean age 65.5 years, brachial BP 145/88 mmHg, current smokers 14{\%}, never smoked 41{\%}, diabetic 18{\%}, arterial disease 11{\%}, daily aspirin 16{\%}, anti-hypertensives 35{\%} and statin therapy 44{\%}. Mean aortic diameter (ITI) was 1.81 cms (range 1.28 to 2.45; SD 0.18). Pooled mean differences between-nurses was 0.05 cms (95{\%} CI 0.02 to 0.08); 2SD ±0.23 with 95{\%} LOA -0.18 to 0.28 cms. Repeatability was similar in both planes and for both pairs of nurses.CONCLUSION: Nurses can achieve a high level of agreement in the measurement of aortic diameter in a routine clinical setting.",
author = "Crilly, {Michael A} and Alison Mundie and Paul Bachoo and Penny Bruce and Colvin, {Fiona A} and Geddes, {Wendy A} and Smart, {Hazel E}",
note = "Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.",
year = "2016",
month = "5",
doi = "10.1016/j.avsg.2015.11.020",
language = "English",
volume = "33",
pages = "194--201",
journal = "Annals of Vascular Surgery",
issn = "0890-5096",
publisher = "Elsevier",

}

TY - JOUR

T1 - Clinical agreement between nurses in the ultrasound measurement of abdominal aortic diameter within a national screening programme

AU - Crilly, Michael A

AU - Mundie, Alison

AU - Bachoo, Paul

AU - Bruce, Penny

AU - Colvin, Fiona A

AU - Geddes, Wendy A

AU - Smart, Hazel E

N1 - Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

PY - 2016/5

Y1 - 2016/5

N2 - BACKGROUND: Accurate measurement is central to AAA-screening, but information concerning differences between-observers using modern ultrasound devices is lacking. Our aim was to assess clinical agreement among nurses within a national screening programme.MATERIAL AND METHODS: Between-observer repeatability was assessed among two pairs of nurses (A&B; C&D) screening a consecutive series of men at a single community-clinic in Grampian, Scotland. All four nurses used the same ultrasound device (GE-LOGIQe 1.5-4.6 MHz curvilinear probe) to measure maximal infrarenal inner-to-inner (ITI) anteroposterior diameter in longitudinal and transverse planes. Nurses alternated in their measurements and were blinded to their partners' measurements. Participants remained supine whilst 'double-scanned'. Clinical agreement was assessed as twice the standard deviation (2SD) of mean differences. Analysis was undertaken using IBM-SPSS-Statistics (version 22) using the Bland-Altman 'limits of agreement' (95% LoA) approach (mean difference ±2SD) and related plots.RESULTS: A total of 63 consecutive men underwent assessment (30 men by nurses A&B; 33 men by nurses C&D). Mean age 65.5 years, brachial BP 145/88 mmHg, current smokers 14%, never smoked 41%, diabetic 18%, arterial disease 11%, daily aspirin 16%, anti-hypertensives 35% and statin therapy 44%. Mean aortic diameter (ITI) was 1.81 cms (range 1.28 to 2.45; SD 0.18). Pooled mean differences between-nurses was 0.05 cms (95% CI 0.02 to 0.08); 2SD ±0.23 with 95% LOA -0.18 to 0.28 cms. Repeatability was similar in both planes and for both pairs of nurses.CONCLUSION: Nurses can achieve a high level of agreement in the measurement of aortic diameter in a routine clinical setting.

AB - BACKGROUND: Accurate measurement is central to AAA-screening, but information concerning differences between-observers using modern ultrasound devices is lacking. Our aim was to assess clinical agreement among nurses within a national screening programme.MATERIAL AND METHODS: Between-observer repeatability was assessed among two pairs of nurses (A&B; C&D) screening a consecutive series of men at a single community-clinic in Grampian, Scotland. All four nurses used the same ultrasound device (GE-LOGIQe 1.5-4.6 MHz curvilinear probe) to measure maximal infrarenal inner-to-inner (ITI) anteroposterior diameter in longitudinal and transverse planes. Nurses alternated in their measurements and were blinded to their partners' measurements. Participants remained supine whilst 'double-scanned'. Clinical agreement was assessed as twice the standard deviation (2SD) of mean differences. Analysis was undertaken using IBM-SPSS-Statistics (version 22) using the Bland-Altman 'limits of agreement' (95% LoA) approach (mean difference ±2SD) and related plots.RESULTS: A total of 63 consecutive men underwent assessment (30 men by nurses A&B; 33 men by nurses C&D). Mean age 65.5 years, brachial BP 145/88 mmHg, current smokers 14%, never smoked 41%, diabetic 18%, arterial disease 11%, daily aspirin 16%, anti-hypertensives 35% and statin therapy 44%. Mean aortic diameter (ITI) was 1.81 cms (range 1.28 to 2.45; SD 0.18). Pooled mean differences between-nurses was 0.05 cms (95% CI 0.02 to 0.08); 2SD ±0.23 with 95% LOA -0.18 to 0.28 cms. Repeatability was similar in both planes and for both pairs of nurses.CONCLUSION: Nurses can achieve a high level of agreement in the measurement of aortic diameter in a routine clinical setting.

U2 - 10.1016/j.avsg.2015.11.020

DO - 10.1016/j.avsg.2015.11.020

M3 - Article

VL - 33

SP - 194

EP - 201

JO - Annals of Vascular Surgery

JF - Annals of Vascular Surgery

SN - 0890-5096

ER -