Validation of Epworth Richmond's Echocardiography Education Focused Year (VEREEFY)

The use of echocardiography in intensive care is a developing field. In expert hands echocardiography has proven its utility in diagnosing cardiac pathology, differentiating shock states and in haemodynamic monitoring. However, whether the results obtained by experts can be generalized to trainees or specialists with limited training remains unclear. Further, concerns around training time and cost for intensive care staff have been a factor in limiting the uptake of echocardiography in intensive care.

The investigators aim to assess the diagnostic accuracy of Australian ICU doctors in training after completion of the current minimum training. After completing a structured teaching program and 30 mentored training scans trainees will be assessed on their accuracy with echocardiography. In the research phase trainees will complete a further 40 scans with each one matched with an expect scan. The results from the expert and trainee scans will be compared to determine the trainee's accuracy.

Study Overview

• Status: Completed
• Conditions: Shock, Cardiogenic; Pulmonary Embolism; Hypovolemia; Cardiac Tamponade
• Intervention / Treatment: Behavioral: Epworth Richmond's Echocardiography Focused Year

• Study Type: Observational
• Enrollment (Actual): 252

Contacts and Locations

Study Locations

• Australia
  • Victoria
    • Melbourne, Victoria, Australia, 3121
      • Epworth Richmond

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Registrar Participants and Patient Participant

Description

Registrar Inclusion:

• At least 12 month appointment in Epworth Richmond ICU
• Completion of theoretical component of Epworth Richmond ICU echocardiography program
• Completion of 30 echocardiography scans

Registrar Exclusion:

• Previous experience in echocardiography prior to commencing at Epworth Richmond.

Patient Inclusion

• Patient in ICU or CCU
• 18 years or older
• Not likely to be discharged before completion of the scan

Patient Exclusion

• Likely to be discharged within next two hours
• Atrial fibrillation
• Presence of subcostal or intercostal drains or pneumothorax
• Unable to be consented
• Treating intensivist deems inclusion in study not suitable.

Study Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patient Participants; Patient participants are adult patients in the Epworth Richmond Intensive care Unit. They are not the focus of the research but rather represent a general population of ICU patients that require echocardiography in the management of their critical illness. They will be a mix of medical and surgical patients some of whom are receiving mechanical ventilation, have movement restrictions, high BMI or other impediments to performing echocardiography.
Registrar Participants; Registrar participants are doctors in training in ICU. They have completed a formal echo teaching program and completed a logbook of 30 supervised scans. They are the focus of the research and are being assessed on their diagnostic accuracy with echocardiography.	Behavioral: Epworth Richmond's Echocardiography Focused Year; a year long echo teaching program

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Agreement between registrar and expert assessment of Left ventricular (LV) function	Four months

Secondary Outcome Measures

Outcome Measure	Time Frame
Comparison of expert and registrar quantitative measures of Left vwentricular Internal Diameter in Diastole (LVIDd)	Four months
Comparison of expert and registrar quantitative measures of Left Ventricular Outflow Tract (LVOT) diameter	Four months
Comparison of expert and registrar quantitative measures of Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI)	Four months
Comparison of expert and registrar quantitative measures of TR V max	Four months
Comparison of expert and registrar quantitative measures of Tricuspid annular Plane Systolic Excursion (TAPSE)	Four months
Comparison of expert and registrar quantitative measures of IVC diameter	Four months
Comparison of expert and registrar qualitative assessment of pericardial fluid	Four months
Comparison of expert and registrar qualitative assessment of Left Ventricle : Right Ventricle size ratio	Four months

Collaborators and Investigators

• Sponsor: Epworth Healthcare
• Collaborators: University of Melbourne

Publications and helpful links

General Publications

• Brooks KS, Tan LH, Rozen TH, Kelly D, McKenzie DP, Calafiore P, Barrett J. Validation of Epworth Richmond's Echocardiography Education Focused Year. Crit Care Med. 2020 Jan;48(1):e34-e39. doi: 10.1097/CCM.0000000000004076.

Study record dates

Study Major Dates

• Study Start: November 1, 2016
• Primary Completion (Actual): May 1, 2017
• Study Completion (Actual): May 1, 2017

Study Registration Dates

• First Submitted: November 3, 2016
• First Submitted That Met QC Criteria: November 8, 2016
• First Posted (Estimate): November 11, 2016

Study Record Updates

• Last Update Posted (Actual): August 10, 2017
• Last Update Submitted That Met QC Criteria: August 9, 2017
• Last Verified: August 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Ischemia; Pathologic Processes; Necrosis; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Respiratory Tract Diseases; Lung Diseases; Embolism and Thrombosis; Shock; Myocardial Infarction; Infarction; Embolism; Shock, Cardiogenic; Pulmonary Embolism; Hypovolemia; Cardiac Tamponade
• Other Study ID Numbers: EH2016-133

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No