Use of contrast agents with echocardiography in patients with suboptimal echocardiography: an evidence-based analysis.
Notice bibliographique
Résumé
OBJECTIVE: The objective of this report is to assess the ability of microbubble contrast agents to enhance the visualization of cardiac structures in patients with suboptimal echocardiography results. CONTRAST ECHOCARDIOGRAPHY: The most common use of contrast echocardiography is the enhancement of the endocardial border. Left ventricular (LV) opacification with contrast echocardiography has the potential to improve the definition of the LV border. The aim of contrast echocardiography is to provide better quantification of LV volume and assessment of LV wall motion analysis than echocardiography alone. Some patients, however, are more likely to exhibit poor echocardiograms than others. These patients include critically ill patients on ventilators or with lung problems, patients who've had recent chest operations, and obese patients. Echocardiography studies performed in the intensive care unit (ICU) are frequently inadequate or suboptimal because of the difficulties in positioning patients properly, poor lighting, chest tubes and bandages. Contrast agents could potentially be used in 5% to 10% of resting echocardiography exams and in an estimated 30% of stress echocardiography tests due to suboptimal echocardiograms. The American Society of Echocardiography guidelines stated that 75% to 90% of suboptimal echocardiography results can yield interpretable results with the use of contrast agents. RESEARCH QUESTION: Do contrast agents improve the visualization of the cardiac structures in patients exhibiting suboptimal echocardiograms? LITERATURE SEARCH: A literature searches was performed on June 22, 2009 using OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published since 1950. Abstracts were reviewed by a single reviewer and, for those studies meeting the eligibility criteria; full-text articles were obtained. Reference lists were also examined for any additional relevant studies not identified through the search. INCLUSION CRITERIA: Systematic reviews, meta-analyses, randomized controlled trials, observational studiesMinimum sample size of 20 enrolled patientsThe contrast agent used in the study must be licensed by Health Canada (at least Notice of Compliance)Patient population must include patients with suboptimal echocardiography resultsCompares echocardiography without contrast to echocardiography with contrastEnglishHuman EXCLUSION CRITERIA: Non-systematic reviews, case reportsGrey literature (e.g. conference abstracts) OUTCOMES OF INTEREST: Change in visualization with and without contrast agent SUMMARY OF FINDINGS: Based on the results of this review: Five studies consistently demonstrated that the addition of contrast to echocardiography improves heart visualization in patients with previously uninterpretable or suboptimal echocardiography results.Suboptimal echocardiography was consistently defined as >2 contiguous segments not seen in non- contrast images.The additional cost of using contrast agents in Ontario would range from approximately $5M to $30M annually.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,035 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,003 |
| Bibliométrie | 0,007 | 0,008 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».