State-of-the-Art Review
A Practical Guide to Assess the Reproducibility of Echocardiographic Measurements

https://doi.org/10.1016/j.echo.2019.08.015Get rights and content
Under a Creative Commons license
open access

Highlights

  • •

    Good reproducibility, repeatability, and reliability are essential for echo studies.

  • •

    Straightforward statistical evaluation can improve echocardiography practice.

  • •

    A free online tool is available at www.birmingham.ac.uk/echo.

Echocardiography plays an essential role in the diagnosis and assessment of cardiovascular disease. Measurements derived from echocardiography are also used to determine the severity of disease, its progression over time, and to aid in the choice of optimal therapy. It is therefore clinically important that echocardiographic measurements be reproducible, repeatable, and reliable. There are a variety of statistical tests available to assess these parameters, and in this article the authors summarize those available for use by echocardiographers to improve their clinical practice. Correlation coefficients, linear regression, Bland-Altman plots, and the coefficient of variation are explored, along with their limitations. The authors also provide an online tool for the easy calculation of these statistics in the clinical environment (www.birmingham.ac.uk/echo). Quantifying and enhancing the reproducibility of echocardiography has important potential to improve the value of echocardiography as the basis for good clinical decision-making.

Keywords

Echocardiography
Reproducibility
Repeatability
Reliability

Abbreviations

ICC
Intraclass correlation coefficient
LVEF
Left ventricular ejection fraction

Cited by (0)

Dr. Kotecha is supported by a National Institute for Health Research (NIHR) Career Development Fellowship (CDF-2015-08-074). Ms. Bunting is funded through this fellowship as a research assistant and PhD student. Dr. Kotecha and Ms. Bunting are supported through an Accelerator Award of the British Heart Foundation awarded to the University of Birmingham Institute of Cardiovascular Sciences (AA/18/2/34218). Dr. Gkoutos acknowledges support from H2020-EINFRA (731075) and the National Science Foundation (IOS:1340112) as well as support from the NIHR Birmingham Experimental Cancer Medicine Centre, NIHR Birmingham Surgical Reconstruction and Microbiology Research Centre, and NIHR Birmingham Biomedical Research Centre and Medical Research Council Health Data Research UK (HDRUK/CFC/01). The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR, the Medical Research Council, or the Department of Health. Dr. Kotecha is chief investigator of the RATE-AF clinical trial (NCT02391337); is Steering Committee lead for the Beta-blockers in Heart Failure Collaborative Group (NCT00832442); has received a Career Development Fellowship from the NIHR (CDF-2015-08-074); is the recipient of a British Heart Foundation project grant (PG/17/55/33087); collaborates on a European Union/EFPIA Innovative Medicines Initiative Grant (BigData@Heart; #116074); and has received fees from Bayer and Atricure. Dr. Rogers has received grants from the NIHR and consultancy fees from Bayer, Quintiles-IMS, and the Institute of Cancer Research, all outside the submitted work.

Conflicts of Interest: None.

2019 by the American Society of Echocardiography. Published by Elsevier Inc.