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European Journal of Echocardiography Advance Access originally published online on September 17, 2008
European Journal of Echocardiography 2009 10(2):314-318; doi:10.1093/ejechocard/jen248
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org.

Report on a national echocardiography quality-control exercise

Kevin F. Fox1,3,*, Andrew Porter2, Beth Unsworth2, Tim Collier3, Graham Leech1 and Jamil Mayet1,3

1 British Society of Echocardiography, DBC, 10–16 Tiller Road, Docklands, London E14 8PX, UK
2 Imperial College Healthcare NHS Trust, UK
3 Imperial College, London, UK

Received 26 May 2008; accepted after revision 31 August 2008; online publish-ahead-of-print 17 September 2008.

* Corresponding author: Cardiovascular Research Group at Charing Cross Hospital, National Heart and Lung Institute, Faculty of Medicine, Imperial College of Science, Technology and Medicine, Department of Cardiology, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK. Tel: +44 208 846 1917; fax: +44 208 746 8182. E-mail address: k.fox{at}imperial.ac.uk


  Abstract

Aims: To assess the feasibility of conducting a large-scale quality-control exercise on the echocardiographic grading of mitral regurgitation (MR).

Methods and results: One hundred and fifty-two practising cardiologist and sonographer echocardiographers attended a dedicated session within a national meeting and were asked to review echocardiographic images of five case studies and evaluate the severity of MR using a six-point scale. The group's overall evaluation was analysed together with the variation in grading of severity. The proportion of gradings of MR more than one grade either side of the mode was <10% in all but one case, and <10% were inaccurately evaluated as inside categories of severe when the modal grading was outside and vice versa. However in a case where a single grading difference had important clinical implications, substantial variability was seen.

Conclusions: Conducting a large-scale quality-control exercise in the assessment of mitral regurgitation is feasible. Overall results suggesting reasonable consistency in reporting may hide substantial clinically relevant variability. It is essential that increasing importance is attached to the development, conduct, and analysis of quality control within echocardiography if it is to maintain and extend its role as a key investigation for patients with heart disease.

Keywords: Echocardiography; Mitral regurgitation; Quality Control


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