Agreement of an echocardiogram-based diagnosis of pulmonary hypertension in infants at risk for bronchopulmonary dysplasia among masked reviewers.

Journal Article (Journal Article;Multicenter Study)

OBJECTIVE: To evaluate the agreement of an echocardiogram-based pulmonary hypertension diagnosis in premature infants at risk for bronchopulmonary dysplasia (BPD). STUDY DESIGN: Echocardiograms from infants born ≤28 weeks post menstrual age were retrospectively reviewed with a standardized reading protocol by three pediatric cardiologists masked to patient's clinical history to determine the presence of pulmonary hypertension. RESULTS: A total of 483 echocardiograms from 49 unique patients were each reviewed by three pediatric cardiologists. Overall there was an 82.9% agreement on the presence of pulmonary hypertension among the three readers (95% CI: 78.4%, 85.4%) with a modified Fleiss' kappa of 0.759 (95% CI: 0.711, 0.801). Percent agreement between rereads was 92.4%, and modified Fleiss' kappa was 0.847 (95% CI: 0.750, 0.931). CONCLUSIONS: Using a standardized reading protocol and echocardiogram-based definition of pulmonary hypertension, there is high inter- and intra-rater agreement for the diagnosis of pulmonary hypertension in at-risk premature infants, suggesting echocardiography can be successfully used for clinical and research monitoring of pulmonary hypertension in infants.

Full Text

Duke Authors

Cited Authors

  • McCrary, AW; Barker, PCA; Torok, RD; Spears, TG; Li, JS; Hornik, CP; Laughon, MM

Published Date

  • February 2019

Published In

Volume / Issue

  • 39 / 2

Start / End Page

  • 248 - 255

PubMed ID

  • 30464221

Pubmed Central ID

  • PMC6724723

Electronic International Standard Serial Number (EISSN)

  • 1476-5543

Digital Object Identifier (DOI)

  • 10.1038/s41372-018-0277-6


  • eng

Conference Location

  • United States