Comparison of visual estimate with digital caliper measurement of coronary artery stenosis

Schweiger, Marc J.; Stanek, Ed; Iwakoshi, Kenny; Hafer, Jocelyn F.; Jacob, Andrew S.; Tullner, William W.; Gianelly, Ralph E.

doi:10.1002/ccd.1810130404

Cited by 12 publications

(1 citation statement)

References 12 publications

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“…Not surprisingly, visual interpretation of coronary arteriograms has been shown to be inaccurate. [10][11][12] Fleming et al 10 demonstrated in 241 coronary studies that 38% were significantly overestimated by visual interpretation. Another study by Schwieger et al 11 compared four interpreters' measurements of coronary stenosis using both a digital caliber computer program and visual estimation.…”

Section: Discussionmentioning

confidence: 99%

The inaccuracy of simple visual interpretation for measurement of carotid stenosis by arteriography

Schmittling

McLafferty

Danetz

et al. 2005

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

The inaccuracy of simple visual interpretation for measurement of carotid stenosis by arteriography

Schmittling

McLafferty

Danetz

et al. 2005

Journal of Vascular Surgery

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Assessment, of coronary angioplasty: Comparison of visual assessment, hand‐held caliper measurement and automated digital quantitation

Katritsis

et al. 1988

Cathet. Cardiovasc. Diagn.

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Digital subtraction coronary angiograms (DSA) of 27 patients who had undergone coronary angioplasty (PTCA) to a total of 32 lesions were analyzed using an automated border-detecting computer program and hand-held caliper measurement of diameter percent stenosis. The results were compared with visual interpretation of the 35-mm cineangiograms. Visual reports significantly overestimated the pre-PTCA diameter percent stenosis (P less than .001) and underestimated the residual post-PTCA narrowing compared with the automatic computer program (P less than .001). Caliper measurements overestimated significantly the pre-PTCA stenosis in comparison with the computer (P less than .01), but post-PTCA the two methods did not differ significantly (P = .105). There was a positive but poor correlation between caliper and computer measurements (r = .43, P less than .05) performed on the pre-PTCA digital angiograms. Post-PTCA the two methods correlated better (r = 0.78, P less than .001), but further statistical analysis showed important discrepancies between them. The correlation of visual reports and computer measurements was poor pre-PTCA (Kendall's tau = 0.32, P less than .05) and not statistically significant post-PTCA (tau = 0.64, P = .5). We conclude that there is observer bias in the visual reporting of angioplasty results, so that pre-PTCA lesions are overestimated, whereas post-PTCA are underestimated. Hand-held caliper measurement improves the assessment of coronary stenoses in comparison with the visual report but still may not altogether eliminate observer bias; it may overestimate the pre-PTCA stenoses compared with automated border detection.

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Discrepancy between visual estimation and computer‐assisted measurement of lesion severity before and after coronary angioplasty

Desmet¹,

Willems²,

Lierde³

et al. 1994

Cathet. Cardiovasc. Diagn.

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One hundred fourteen coronary stenoses were quantified before and after percutaneous transluminal coronary angioplasty (PTCA) using a semi-automated digital system. The values obtained were considered as standard for comparison with visual estimation by the PTCA operator as well as by independent consensus-reading. The measured percent stenosis was 62.7 +/- 13.7% before and 27.7 +/- 12.4% after angioplasty. Before PTCA, the operator consistently overestimated stenosis severity (87.8 +/- 8.5%, P < 0.0001) and consensus-reading reduced but did not eliminate this overestimation (78.0 +/- 12.3%, P < 0.05). The error in visual estimation was inversely correlated with the measured degree of stenosis: coefficients were -0.79 (P < 0.0001) and -0.51 (P < 0.0001) for operator and consensus-readers, respectively. After PTCA, the operator underestimated the residual stenosis (21.2 +/- 9.9%, P < 0.0001) but there was no systematic bias by consensus-reading (29.4 +/- 12.0%, NS). Again the error in visual estimation was inversely correlated with the measured degree of residual stenosis: coefficients were -0.76 (P < 0.0001) and -0.58 (P < 0.0001) for operator and consensus-reading, respectively. In conclusion, the operator overestimates lesion severity before and underestimates moderate residual stenoses after PTCA, a problem only partially corrected by independent consensus-readers.

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Comparison of visual estimate with digital caliper measurement of coronary artery stenosis

Cited by 12 publications

References 12 publications

The inaccuracy of simple visual interpretation for measurement of carotid stenosis by arteriography

The inaccuracy of simple visual interpretation for measurement of carotid stenosis by arteriography

Assessment, of coronary angioplasty: Comparison of visual assessment, hand‐held caliper measurement and automated digital quantitation

Discrepancy between visual estimation and computer‐assisted measurement of lesion severity before and after coronary angioplasty

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