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Roberts-Thomson R, Baumann A, Reade J, Culgan L, Kaethner A, Remenyi B, Chew D, Ilton M, Kangaharan N, Sinhal A, Bennetts J, Nicholls S, Psaltis P, Brown A. 705 Rates of Surgical Intervention in Aboriginal Patients With Significant Rheumatic Heart Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Roberts-Thomson R, Baumann A, Reade J, Culgan L, Kaethner A, Remenyi B, Wheaton G, Mu M, Ilton M, Kangaharan N, Tayeb H, Nicholls S, Psaltis P, Brown A. 006 Left Atrial Ejection Fraction Predicts Future need for Surgery in Asymptomatic Patients With Rheumatic Mitral Valve Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Francis J, Fairhurst H, Kaethner A, Whalley G, Ryan C, Dos Santos J, Reeves B, Wheaton G, Horton A, Marangou J, Francis L, Hardefeldt H, Davis K, Engelman D, Remenyi B. P3133Single parasternal long axis echocardiography by briefly trained health workers using handheld devices for detection of rheumatic heart disease: a prospective study of diagnostic accuracy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Echocardiographic screening can detect rheumatic heart disease (RHD) in high-risk populations,but is limited by reliance on highly-trained experts and equipment. We sought to determine the diagnostic utility of an ultra-abbreviated single parasternal-long-axis-sweep of the heart (SPLASH) echocardiography protocol to detect RHD, performed by briefly-trained health workers.
Methods
In Timor-Leste and Northern Australia, individuals aged 5–20y were offered school-based echocardiographic screening. Health workers completed online modules followed by one-week of practical training, logging 50 echocardiograms prior to study. The index test was SPLASH, performed and reported by health workers using handheld GE V-scan devices. The index test was abnormal if any mitral or aortic regurgitation was detected. The reference test was a comprehensive echocardiogram, performed by an echocardiographers or cardiologist on a GE Vivid-Q, reported according to World Heart Federation criteria. The diagnostic accuracy of the index test was determined.
Results
2590 subjects underwent index and reference tests. Prevalence of definite RHD was 3.2% (83/2590). Sensitivity and specificity of index test were 0.75 (95% CI 0.64–0.83) and 0.77 (95% CI 0.75–0.78) respectively for detection of any definite RHD, and 0.91 (95% CI 0.74–0.98) and 0.76 (95% CI 0.74–0.78) respectively for detection of moderate or severe RHD.
Conclusion
Health workers using SPLASH detected the vast majority of moderate and severe RHD cases, but lacked sensitivity for detection of mild RHD. Further analysis is underway to evaluate the learning curve and other performance indicators of health workers performing and interpreting echocardiograms. This will allow refinement of SPLASH protocol and augmentation of health worker training to increase detection rates and accuracy for future population screening initiatives.
Acknowledgement/Funding
Heart Foundation Australia Vanguard Grant, Menzies HOT-NORTH pilot project grant, Snow Foundation, Rotary, Bawinanga Aboriginal Corporation, Mala'la
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Affiliation(s)
- J Francis
- Menzies School of Health Research, Darwin, Australia
| | - H Fairhurst
- Menzies School of Health Research, Darwin, Australia
| | | | - G Whalley
- University of Otago, Division of Health Sciences, Otago, New Zealand
| | - C Ryan
- Maningrida Health Centre, Darwin, Australia
| | | | - B Reeves
- Cairns Hospital, Cairns, Australia
| | - G Wheaton
- Women's and Children's Hospital, Adelaide, Australia
| | - A Horton
- Monash University, Melbourne, Australia
| | | | - L Francis
- Royal Darwin Hospital, Department of Paediatrics, Darwin, Australia
| | - H Hardefeldt
- Royal Darwin Hospital, Department of Paediatrics, Darwin, Australia
| | - K Davis
- Royal Darwin Hospital, Department of Paediatrics, Darwin, Australia
| | - D Engelman
- Murdoch Children's Research Institute, Melbourne, Australia
| | - B Remenyi
- Menzies School of Health Research, Darwin, Australia
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Doran J, Remeny B, Ilton M, Canty D, Cass A, Dempsey K, Townsend R, Royse C, Royse A, Kaethner A, Brunsdon G, Boardmann C, Bennets J, Baker R, Oatway S, Thiele B, Perry D, Doran K, Doran U, Grey N, Kangaharan N. Retrospective Audit of Rheumatic Heart Valve Surgical Outcomes in the Top End of Northern Territory, Australia. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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