Heterogeneity of Doppler waveform description is decreased with the use of a dedicated classification
Abstract
Abstract.Background: The analysis of Doppler ultrasound waveforms (DW) provides a method for detecting and evaluating arterial stenosis in the lower limb arteries but no recommendation exists on how to describe the DWs. Aims of this study were to assess the heterogeneity of the description of DWs among vascular residents and the impact of the use of a 4-item classification. Methods: Thirty different DWs were presented to residents using Microsoft PowerPoint® slides. They were invited to describe the 30 DWs before and after the presentation of a 4-item classification (triphasic, biphasic, monophasic, and others). The heterogeneity was assessed by the number of different answers used by the residents. Nineteen residents with six to eighteen months of vascular medicine training and ultrasound experience were included. Results: The average of different answers was 9 ± 4 for the whole analysis of the 30 DWs without the use of a specific classification, whereas the average was 2 ± 1 using the 4-item classification (p < 0.005). There was a significant difference in correct answers, i. e. in combined continuous waveforms and pulsed waveforms between experienced residents and younger residents (p < 0.05). Conclusions: 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.
Literature
Transcutaneous ultrasonic imaging in peripheral vascular diseases. Am J Card Imaging. 1993;7:99–108.
.Three-dimensional display of calculated velocity profiles for physiological flow waveforms. J Vasc Surg. 1993;17:656–60.
.Doppler waveform parvus and tardus. A sign of proximal flow obstruction. J Ultrasound Med Off J Am Inst Ultrasound Med. 1989;8:435–40.
.Statement for Doppler waveforms analysis. VASA Z Gefasskrankheiten. 2017:1–9.
Characterizing Triphasic, Biphasic, and Monophasic Doppler Waveforms: Should a Simple Task Be So Difficult? J Diagn Med Sonogr. 2008;24:269–76.
.Confusion of Peripheral Arterial Doppler Waveform Terminology. J Diagn Med Sonogr. 2009;25:185–94.
.2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135:e726–79.
Knowledge about ankle-brachial index procedure among residents: being experienced is beneficial but is not enough. VASA Z Gefasskrankheiten. 2016;45:37–41.
.[Classification of changes in circulatory rate in the arteries of the lower limbs. Transcutaneous measurement by Doppler effect]. Nouv Presse Med. 1975;4:2091–3.
.Value of the duplex waveform at the common femoral artery for diagnosing obstructive aortoiliac disease. J Vasc Surg. 2005;42:236–42.
.