Heterogeneity of Doppler waveform description is decreased with the use of a dedicated classification

Abstract

Using a 4-item classification for DWs reduced the heterogeneity of the DW description. There is an urgent need to standardize the DW description in order to improve the patients care with peripheral artery disease.

Inter-rater Reliability of 4-Item Arterial Doppler Waveform Classification System for Description of Arterial Doppler Waveforms

“…Another study among French vascular medicine residents using the same arterial DW questionnaire found a higher percentage of correct responses (82%) but with a small sample size. Of interest the reliability of the classification was not evaluated in this study due to a too small sample size (n = 19) (8). The high rate of good response can be explained by the fact that vascular medicine residents were familiar with the Doppler waveform analysis during the initial vascular medicine training.…”

“…In our investigation, the 4-category classification system produced "moderate" or "weak" inter-rater interpretation reliability (κ = 0.522, CI95%: 0.520-0.523, p < 0.005). Previous investigations have demonstrated the importance of having a definitive classification system to reduce the heterogeneity of DW descriptions (8)(9)(10). To prevent DW characterization from being excessively discriminatory the classification system should not be too restrictive, e.g., normal and abnormal (two categories).…”

“…While arterial DW analysis is commonly used for the categorization of PAD severity (6), waveform definitions are not standardized and have contradictory characteristics for the same waveform descriptor in literature (7). These inconsistencies have perpetuated confusion in DW classification by vascular ultrasound professionals and other medical care providers (8). Studies have demonstrated there is significant heterogeneity in DW descriptions of physicians and residents, which can be significantly reduced with standardized waveform nomenclature (8,9).…”

“…These inconsistencies have perpetuated confusion in DW classification by vascular ultrasound professionals and other medical care providers (8). Studies have demonstrated there is significant heterogeneity in DW descriptions of physicians and residents, which can be significantly reduced with standardized waveform nomenclature (8,9). A 4-category arterial DW classification (triphasic, biphasic, monophasic, and others) has previously been reported (10), however, the reliability of this classification has only been studied on small and heterogeneous population in the United States (US) and remains unknown in China.…”

Recommandations du Collège des enseignants de médecine vasculaire (CEMV) : analyse des flux artériels Doppler (classification de Saint-Bonnet simplifiée)

“…-Un IPS de repos ≤ 0,90 -Un IPS de repos ≤ 0,90 et un flux Doppler « anormal » -Un IPS de repos ≤ 0,90 et un flux Doppler normal (triphasique) -Un IPS de repos > 0,90 et un flux Doppler « anormal » La grande difficulté d'utiliser l'analyse des flux Doppler est liée au fait que la description/dénomination des différents flux artériels Doppler est à ce jour très hétérogène [4,12].…”