Determining the Extent of Agreement for Determining the Echographic Ejection Fraction Determined by Emergency Medicine Residents Compared with a Cardiologist

Abstract

Objective: The aim of this study was to determine the extent of agreement on the measured echographic ejection fraction measured by emergency medicine (EM) residents compared with a cardiologist. Materials and Methods: This study was conducted with cardiac patients admitted to a hospital emergency department in Tehran, Iran. A total of 156 patient cases were reviewed. A group of trained EM residents evaluated the ejection fraction (EF) of these patients utilizing three different methods: Simpson’s method (N = 50), E-Point Septal Separation (EPSS, N = 56), and a visual technique (N = 50). A final assessment was made for all patients by a cardiologist. Results: In 69.3% of these patient cases, there was a significant correlation between the EM residents’ report and the cardiologists, with Cohen’s Kappa coefficient of .746 ( P < .001). The Kappa coefficient for the visual technique, Simpson’s method, and EPSS was .697, .467, and .487, respectively. The sensitivity, specificity, positive and negative predictive values of EF measurements, provided by the EM residents, were 0.89%, 64.2%, 81.6%, and 76.5% compared with the cardiologist, respectively. Conclusion: This description study was done to determine the agreement of echocardiographic measurement of EF, assessed by trained EM residents, compared with a cardiologist’s review. In this case, the results demonstrated moderate to good agreement.