Evaluation of a focussed protocol for hand-held echocardiography and computer-assisted auscultation in detecting latent rheumatic heart disease in scholars
Introduction Echocardiography is the diagnostic test of choice for latent rheumatic heart disease. The utility of echocardiography for large-scale screening is limited by high cost, complex diagnostic protocols, and time to acquire multiple images. We evaluated the performance of a brief hand-held e...
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| Veröffentlicht in: | Cardiology in the young 2016-08, Vol.26 (6), p.1097-1106 |
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| creator | Zühlke, Liesl J. Engel, Mark E. Nkepu, Simpiwe Mayosi, Bongani M. |
| description | Introduction Echocardiography is the diagnostic test of choice for latent rheumatic heart disease. The utility of echocardiography for large-scale screening is limited by high cost, complex diagnostic protocols, and time to acquire multiple images. We evaluated the performance of a brief hand-held echocardiography protocol and computer-assisted auscultation in detecting latent rheumatic heart disease with or without pathological murmur.
A total of 27 asymptomatic patients with latent rheumatic heart disease based on the World Heart Federation criteria and 66 healthy controls were examined by standard cardiac auscultation to detect pathological murmur. Hand-held echocardiography using a focussed protocol that utilises one view - that is, the parasternal long-axis view - and one measurement - that is, mitral regurgitant jet - and a computer-assisted auscultation utilising an automated decision tool were performed on all patients.
The sensitivity and specificity of computer-assisted auscultation in latent rheumatic heart disease were 4% (95% CI 1.0-20.4%) and 93.7% (95% CI 84.5-98.3%), respectively. The sensitivity and specificity of the focussed hand-held echocardiography protocol for definite rheumatic heart disease were 92.3% (95% CI 63.9-99.8%) and 100%, respectively. The test reliability of hand-held echocardiography was 98.7% for definite and 94.7% for borderline disease, and the adjusted diagnostic odds ratios were 1041 and 263.9 for definite and borderline disease, respectively.
Computer-assisted auscultation has extremely low sensitivity but high specificity for pathological murmur in latent rheumatic heart disease. Focussed hand-held echocardiography has fair sensitivity but high specificity and diagnostic utility for definite or borderline rheumatic heart disease in asymptomatic patients. |
| doi_str_mv | 10.1017/S1047951115001857 |
| format | Article |
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A total of 27 asymptomatic patients with latent rheumatic heart disease based on the World Heart Federation criteria and 66 healthy controls were examined by standard cardiac auscultation to detect pathological murmur. Hand-held echocardiography using a focussed protocol that utilises one view - that is, the parasternal long-axis view - and one measurement - that is, mitral regurgitant jet - and a computer-assisted auscultation utilising an automated decision tool were performed on all patients.
The sensitivity and specificity of computer-assisted auscultation in latent rheumatic heart disease were 4% (95% CI 1.0-20.4%) and 93.7% (95% CI 84.5-98.3%), respectively. The sensitivity and specificity of the focussed hand-held echocardiography protocol for definite rheumatic heart disease were 92.3% (95% CI 63.9-99.8%) and 100%, respectively. The test reliability of hand-held echocardiography was 98.7% for definite and 94.7% for borderline disease, and the adjusted diagnostic odds ratios were 1041 and 263.9 for definite and borderline disease, respectively.
Computer-assisted auscultation has extremely low sensitivity but high specificity for pathological murmur in latent rheumatic heart disease. Focussed hand-held echocardiography has fair sensitivity but high specificity and diagnostic utility for definite or borderline rheumatic heart disease in asymptomatic patients.</description><identifier>ISSN: 1047-9511</identifier><identifier>EISSN: 1467-1107</identifier><identifier>DOI: 10.1017/S1047951115001857</identifier><identifier>PMID: 26423122</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adolescent ; Adult ; Case-Control Studies ; Child ; Diagnosis, Computer-Assisted ; Echocardiography - standards ; Female ; Heart Auscultation - standards ; Heart Murmurs - diagnosis ; Humans ; Male ; Mass Screening ; Mitral Valve Insufficiency - diagnosis ; Original Articles ; Reproducibility of Results ; Rheumatic Heart Disease - diagnosis ; Sensitivity and Specificity ; South Africa ; Young Adult</subject><ispartof>Cardiology in the young, 2016-08, Vol.26 (6), p.1097-1106</ispartof><rights>Cambridge University Press 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-51b30caa8492f550f7786119eed49677e30029518212d5bfb4cec27a2059c4ac3</citedby><cites>FETCH-LOGICAL-c406t-51b30caa8492f550f7786119eed49677e30029518212d5bfb4cec27a2059c4ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S1047951115001857/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,780,784,27924,27925,55628</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26423122$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zühlke, Liesl J.</creatorcontrib><creatorcontrib>Engel, Mark E.</creatorcontrib><creatorcontrib>Nkepu, Simpiwe</creatorcontrib><creatorcontrib>Mayosi, Bongani M.</creatorcontrib><title>Evaluation of a focussed protocol for hand-held echocardiography and computer-assisted auscultation in detecting latent rheumatic heart disease in scholars</title><title>Cardiology in the young</title><addtitle>Cardiol Young</addtitle><description>Introduction Echocardiography is the diagnostic test of choice for latent rheumatic heart disease. The utility of echocardiography for large-scale screening is limited by high cost, complex diagnostic protocols, and time to acquire multiple images. We evaluated the performance of a brief hand-held echocardiography protocol and computer-assisted auscultation in detecting latent rheumatic heart disease with or without pathological murmur.
A total of 27 asymptomatic patients with latent rheumatic heart disease based on the World Heart Federation criteria and 66 healthy controls were examined by standard cardiac auscultation to detect pathological murmur. Hand-held echocardiography using a focussed protocol that utilises one view - that is, the parasternal long-axis view - and one measurement - that is, mitral regurgitant jet - and a computer-assisted auscultation utilising an automated decision tool were performed on all patients.
The sensitivity and specificity of computer-assisted auscultation in latent rheumatic heart disease were 4% (95% CI 1.0-20.4%) and 93.7% (95% CI 84.5-98.3%), respectively. The sensitivity and specificity of the focussed hand-held echocardiography protocol for definite rheumatic heart disease were 92.3% (95% CI 63.9-99.8%) and 100%, respectively. The test reliability of hand-held echocardiography was 98.7% for definite and 94.7% for borderline disease, and the adjusted diagnostic odds ratios were 1041 and 263.9 for definite and borderline disease, respectively.
Computer-assisted auscultation has extremely low sensitivity but high specificity for pathological murmur in latent rheumatic heart disease. Focussed hand-held echocardiography has fair sensitivity but high specificity and diagnostic utility for definite or borderline rheumatic heart disease in asymptomatic patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Diagnosis, Computer-Assisted</subject><subject>Echocardiography - standards</subject><subject>Female</subject><subject>Heart Auscultation - standards</subject><subject>Heart Murmurs - diagnosis</subject><subject>Humans</subject><subject>Male</subject><subject>Mass Screening</subject><subject>Mitral Valve Insufficiency - diagnosis</subject><subject>Original Articles</subject><subject>Reproducibility of Results</subject><subject>Rheumatic Heart Disease - diagnosis</subject><subject>Sensitivity and Specificity</subject><subject>South Africa</subject><subject>Young Adult</subject><issn>1047-9511</issn><issn>1467-1107</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU-L1TAUxYsozh_9AG4k4MZNNTdJm3Ypw-gIAy7UdblNbl8ztM0zf4T5LPNlzeM9RRTBVULO75zLzamqF8DfAAf99jNwpfsGABrOoWv0o-ocVKtrAK4fl3uR64N-Vl3EeFcYKYE_rc5Eq4QEIc6rh-vvuGRMzm_MTwzZ5E2OkSzbB5-88Ut5CWzGzdYzLZaRmb3BYJ3fBdzP96wozPh1nxOFGmN0MRU35mjyko7BbmOWEpnkth1bMNGWWJgpr0U2bCYMiVkXCSMd2FhGLBjis-rJhEuk56fzsvr6_vrL1U19--nDx6t3t7VRvE11A6PkBrFTvZiahk9ady1AT2RV32pNknNRfqETIGwzTqMyZIRGwZveKDTysnp9zC0rf8sU07C6aGhZcCOf4wAd71otRaf-BwUlemj6gr76A73zOWxlkQPFWwlSy0LBkTLBxxhoGvbBrRjuB-DDoeThr5KL5-UpOY8r2V-On60WQJ5CcR2Dszv6bfY_Y38AA-Wyrg</recordid><startdate>201608</startdate><enddate>201608</enddate><creator>Zühlke, Liesl J.</creator><creator>Engel, Mark E.</creator><creator>Nkepu, Simpiwe</creator><creator>Mayosi, Bongani M.</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7QO</scope></search><sort><creationdate>201608</creationdate><title>Evaluation of a focussed protocol for hand-held echocardiography and computer-assisted auscultation in detecting latent rheumatic heart disease in scholars</title><author>Zühlke, Liesl J. ; Engel, Mark E. ; Nkepu, Simpiwe ; Mayosi, Bongani M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-51b30caa8492f550f7786119eed49677e30029518212d5bfb4cec27a2059c4ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Diagnosis, Computer-Assisted</topic><topic>Echocardiography - standards</topic><topic>Female</topic><topic>Heart Auscultation - standards</topic><topic>Heart Murmurs - diagnosis</topic><topic>Humans</topic><topic>Male</topic><topic>Mass Screening</topic><topic>Mitral Valve Insufficiency - diagnosis</topic><topic>Original Articles</topic><topic>Reproducibility of Results</topic><topic>Rheumatic Heart Disease - diagnosis</topic><topic>Sensitivity and Specificity</topic><topic>South Africa</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zühlke, Liesl J.</creatorcontrib><creatorcontrib>Engel, Mark E.</creatorcontrib><creatorcontrib>Nkepu, Simpiwe</creatorcontrib><creatorcontrib>Mayosi, Bongani M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><jtitle>Cardiology in the young</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zühlke, Liesl J.</au><au>Engel, Mark E.</au><au>Nkepu, Simpiwe</au><au>Mayosi, Bongani M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of a focussed protocol for hand-held echocardiography and computer-assisted auscultation in detecting latent rheumatic heart disease in scholars</atitle><jtitle>Cardiology in the young</jtitle><addtitle>Cardiol Young</addtitle><date>2016-08</date><risdate>2016</risdate><volume>26</volume><issue>6</issue><spage>1097</spage><epage>1106</epage><pages>1097-1106</pages><issn>1047-9511</issn><eissn>1467-1107</eissn><abstract>Introduction Echocardiography is the diagnostic test of choice for latent rheumatic heart disease. The utility of echocardiography for large-scale screening is limited by high cost, complex diagnostic protocols, and time to acquire multiple images. We evaluated the performance of a brief hand-held echocardiography protocol and computer-assisted auscultation in detecting latent rheumatic heart disease with or without pathological murmur.
A total of 27 asymptomatic patients with latent rheumatic heart disease based on the World Heart Federation criteria and 66 healthy controls were examined by standard cardiac auscultation to detect pathological murmur. Hand-held echocardiography using a focussed protocol that utilises one view - that is, the parasternal long-axis view - and one measurement - that is, mitral regurgitant jet - and a computer-assisted auscultation utilising an automated decision tool were performed on all patients.
The sensitivity and specificity of computer-assisted auscultation in latent rheumatic heart disease were 4% (95% CI 1.0-20.4%) and 93.7% (95% CI 84.5-98.3%), respectively. The sensitivity and specificity of the focussed hand-held echocardiography protocol for definite rheumatic heart disease were 92.3% (95% CI 63.9-99.8%) and 100%, respectively. The test reliability of hand-held echocardiography was 98.7% for definite and 94.7% for borderline disease, and the adjusted diagnostic odds ratios were 1041 and 263.9 for definite and borderline disease, respectively.
Computer-assisted auscultation has extremely low sensitivity but high specificity for pathological murmur in latent rheumatic heart disease. Focussed hand-held echocardiography has fair sensitivity but high specificity and diagnostic utility for definite or borderline rheumatic heart disease in asymptomatic patients.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>26423122</pmid><doi>10.1017/S1047951115001857</doi><tpages>10</tpages></addata></record> |
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| ispartof | Cardiology in the young, 2016-08, Vol.26 (6), p.1097-1106 |
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| subjects | Adolescent Adult Case-Control Studies Child Diagnosis, Computer-Assisted Echocardiography - standards Female Heart Auscultation - standards Heart Murmurs - diagnosis Humans Male Mass Screening Mitral Valve Insufficiency - diagnosis Original Articles Reproducibility of Results Rheumatic Heart Disease - diagnosis Sensitivity and Specificity South Africa Young Adult |
| title | Evaluation of a focussed protocol for hand-held echocardiography and computer-assisted auscultation in detecting latent rheumatic heart disease in scholars |
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