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  • 1.
    Lindahl, Bernt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Norberg, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Johansson, Helene
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Lindvall, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Ng, Nawi
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Nordin, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nordin, Steven
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Näslund, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Persson, Amanda
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Schulz, Peter J.
    Institute of Communication and Health, University of Lugano, Switzerland.
    Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk2019Ingår i: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Health literacy, the degree to which individuals understand and act upon health information, may have a pivotal role in the prevention of cardiovascular disease (CVD), with low health literacy potentially explaining poorer adherence to prevention guidelines. We investigated the associations between health literacy, ultrasound-detected carotid atherosclerosis and cardiovascular risk factors.

    Methods: Baseline data (cross-sectional analysis) from a randomized controlled trial, integrated within the Västerbotten Intervention Program, Northern Sweden, was used. We included 3459 individuals, aged 40 or 50 years with ≥1 conventional risk factor or aged 60 years old. The participants underwent clinical examination, blood sampling, carotid ultrasound assessment of intima-media wall thickness (CIMT) and plaque formation, and answered a questionnaire on health literacy – the Brief Health Literacy Screen. The European Systematic Coronary Risk Evaluation and Framingham Risk Score were calculated.

    Results: About 20% of the participants had low health literacy. Low health literacy was independently associated with the presence of ultrasound-detected carotid artery plaques after adjustment for age and education, odds ratio (95% confidence interval) 1.54 (1.28–1.85), demonstrating a similar level of risk as for smoking. Health literacy was associated with CIMT in men. Low health literacy was associated with higher CVD risk scores. Sensitivity analyses with low health literacy set to 9% or 30% of the study sample, respectively, yielded essentially the same results.

    Conclusions: Low health literacy was independently associated with carotid artery plaques and a high level of CVD risk scores. Presenting health information in a fashion that is understood by all patients may improve preventive efforts.

  • 2.
    Mariscalco, Giovanni
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Sessa, Fausto
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Mantovani, Vittorio
    Sandro, Ferrarese
    Sala, Andrea
    Transthoracic echocardiography is adequate for the diagnosis of right coronary artery aneurysms2008Ingår i: Journal of cardiac surgery, ISSN 0886-0440, E-ISSN 1540-8191, Vol. 23, nr 1, s. 72-74Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Coronary artery aneurysms (CAA) are rare but potentially fatal pathologies. This case was referred to our Unit after occasional echocardiographic finding of an intracardiac mass. A new detailed transthoracic echocardiogram was decisive for a diagnosis of a large CAA of the right coronary artery, compressing and dislocating the right atrium. Transesophageal echocardiography was not performed because of the data obtained. The diagnosis was confirmed by cardiac catheterization. The patient was managed with a surgical procedure.

  • 3.
    Nyman, Emma
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Grönlund, Christer
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Lindqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Näslund, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Carotid artery plaque assessment within the Västerbotten intervention programme: VIPVIZA2015Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 241, nr 1, s. E159-E159Artikel i tidskrift (Övrigt vetenskapligt)
  • 4.
    Nyman, Emma
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Grönlund, Christer
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Näslund, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Lindqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Area measurement of carotid plaque comparing B-MODE, Doppler color and contrast-enhanced ultrasound imaging2016Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 252, s. E191-E191Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Objectives: Carotid plaque characteristic analysis are suggested to improve risk stratification. Plaque area and echolucent plaques have shown to correlate with increased risk for cardiovascular diseases. A limitation with B-mode imaging is the uncertainty that the whole plaque area is identified, primarily on echolucent plaques. Contrast-enhanced ultrasound (CEUS) is used to improve carotid imaging including better plaque area measurement. Aim: Evaluate if CEUS could improve accurate plaque area measurement compared with B-mode and Doppler color flow imaging. Methods: The study included 28 participants (50% females, mean age 58 years) with identified asymptomatic carotid plaques. We performed B-mode, Doppler color and CEUS ultrasound imaging whereas the plaque area was manually outdrawn by a single operator. Plaques were also subjectively classified as 1 echogenic, 2 echolucent, or 3 mixed plaques. Results: We did not find a significant difference in plaque area measurements between different ultrasound image modalities having all plaque types included. In the group of echolucent plaques (n= 11) we found a significant different between B-mode and CEUS (p=0.049) and also between B-mode and Doppler color imaging (p=0.039) (Illustrated in Fig 1). Conclusions: Echolucent plaque can be underestimated with B-mode imaging. Use of contrast-enhanced ultrasound should be considered in carotid plaque imaging on echolucent plaques when plaque outline is difficult to identify.

  • 5.
    Nyman, Emma
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Näslund, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Grönlund, Christer
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Inter-sonographer reproducibility of carotid ultrasound plaque detection using Mannheim consensus in subclinical atherosclerosis2020Ingår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 40, nr 1, s. 46-51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To determine the inter-sonographer reproducibility of carotid ultrasound plaque detection using Mannheim consensus in a subclinical population and evaluate associations related to the reproducibility.

    Methods and results: Bilateral ultrasound screening for carotid plaques defined by Mannheim consensus was performed on 106 subclinical participants. Two different sonographers scanned the same participant, and reproducibility of plaque detection was measured by Cohens kappa. Associations with reproducibility were evaluated by comparing wall, and plaque characteristics between subjects with plaques identified in one and both scans. In general, the inter-sonographer reproducibility of plaque detection was substantial with a kappa value of 0 center dot 70 (95% CI 0 center dot 60-0 center dot 80). Plaques detected in only one scan had significantly lower plaque area and plaque thickness (6 center dot 82 mm(2) and 1 center dot 45 mm) as compared to plaques detected in both scans (11 center dot 65 mm(2) and 1 center dot 96 mm, P<0 center dot 001).

    Conclusion: Minor carotid plaques contribute to decreased reproducibility as compared to large plaques when screening for subclinical atherosclerosis using Mannheim consensus. Using an alternative plaque definition based on plaque thickness >1.5 mm and plaque area >10 mm(2) could increase the reproducibility of plaque detection in subclinical atherosclerosis.

  • 6.
    Näslund, Ulf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Lundgren, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Norberg, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Is intima-media thickness a predictor for cardiovascular risk?: Authors' reply2019Ingår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 394, nr 10196, s. 381-381Artikel i tidskrift (Refereegranskat)
  • 7.
    Näslund, Ulf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Ng, Nawi
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lundgren, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Fhärm, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Grönlund, Christer
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Johansson, Helene
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lindahl, Bernt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lindahl, Bertil
    Lindvall, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Nilsson, Stefan K.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Fysiologisk kemi.
    Nordin, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nordin, Steven
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nyman, Emma
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Weinehall, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Wennberg, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Wester, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Norberg, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial2019Ingår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 393, nr 10167, s. 133-142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention.

    METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound assessment of carotid intima media wall thickness and plaque formation. Participants were randomly assigned 1:1 with a computer-generated randomisation list to an intervention group (pictorial representation of carotid ultrasound plus a nurse phone call to confirm understanding) or a control group (not informed). The primary outcomes, Framingham risk score (FRS) and European systematic coronary risk evaluation (SCORE), were assessed after 1 year among participants who were followed up. This study is registered with ClinicalTrials.gov, number NCT01849575.

    FINDINGS: 3532 individuals were enrolled between April 29, 2013, and June 7, 2016, of which 1783 were randomly assigned to the control group and 1749 were assigned to the intervention group. 3175 participants completed the 1-year follow-up. At the 1-year follow-up, FRS and SCORE differed significantly between groups (FRS 1·07 [95% CI 0·11 to 2·03, p=0·0017] and SCORE 0·16 [0·02 to 0·30, p=0·0010]). FRS decreased from baseline to the 1-year follow-up in the intervention group and increased in the control group (-0·58 [95% CI -0·86 to -0·30] vs 0·35 [0·08 to 0·63]). SCORE increased in both groups (0·13 [95% CI 0·09 to 0·18] vs 0·27 [0·23 to 0·30]).

    INTERPRETATION: This study provides evidence of the contributory role of pictorial presentation of silent atherosclerosis for prevention of cardiovascular disease. It supports further development of methods to reduce the major problem of low adherence to medication and lifestyle modification.

  • 8.
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Vascular ultrasound for the assessment of carotid atherosclerosis2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background: Atherosclerotic cardiovascular disease (CVD) is a common cause for mortality globally, and is expected to remain the single leading cause of death as the global population ages and as life expectancy increases.

    Cardiovascular screening models have been developed, and continue to be developed, to identify individuals at high-risk of CVD.  This is necessary to establish prevention strategies to decrease the occurrence of an acute event or debilitating syndrome. These strategies largely take the form of lifestyle modification and pharmacological intervention. The Framingham risk score, NCEP/ATP II guidelines and SCORE risk assessment protocol are widely used screening models. Ultrasound based methods are non-invasive, affordable and have been suggested to improve assessment and definition of individual patients potential risk of CVD. Increased carotid artery intima-media thickness (cIMT) is a known and established sign of early atherosclerosis. The presence of plaque and the overall burden of atherosclerosis seems to have even greater value in predicting cerebrovascular and cardiovascular events. Ultrasound based texture characteristics of plaques such as entropy, grey scale median, discrete white area, coarseness and juxtaluminal hypoechoic black area have been proposed as useful possible predictors of plaque vulnerability. Moreover, ultrasound contrast agents have been developed to improve visualization and subsequent quantification of an atherosclerotic plaque. Considering the current available data and research, the importance of developing tools and techniques for detection and characterization of atherosclerotic changes, to indicate risk for CVD and the subsequent early intervention and prevention, appears clearly as an effort to improve public health. In this present collection of studies (4 papers) we aim to contribute to the development of clinically useful ultrasound methods and tools for the accurate assessment, understanding and management of atherosclerosis.

    Methods: To validate ultrasound-based methods for assessment of early signs of atherosclerosis, measured as cIMT, a total of 144 subjects underwent bilateral carotid ultrasound. In study I, the performance of an ultrasonography software capable of fully automated on-screen cIMT measurements was tested and compared with the traditional manual measurement approach. The coefficient of variation and the intraclass correlation coefficient for both methods were compared to verify the reliability and reproducibility of results generated by the new ultrasound software. To test the accessibility and possible clinical applications of this new technology tested in study I, the new software was used by novice’s scanners in study II, and the intraobserver variability of the cIMT measurements were assessed and compared with that of an expert operator. In study III, ultrasound texture characteristics of 327 plaques including entropy, grey scale median, discrete white area, coarseness and juxtaluminal hypoechoic black area were assessed as possible predictors of future cerebrovascular events in a cohort of 133 patients with symptomatic carotid stenosis waiting for carotid surgery. The reproducibility of measuring plaque area (expressed as intraclass correlation coefficient) using conventional ultrasound and contrast enhanced ultrasound was tested in study IV in an attempt to find a simple and reproducible parameter for monitoring changes in atherosclerotic burden.

    Results: The technology tested in study I was found to have good inter- and intra-system reproducibility compared with conventional methods. Moreover, it was found to produce reproducible results when used by expert and novice operators after a short period of training (study II), confirming the possibility for the employment of this technology in a large screening public health programs. Although such technology may have immediate practical application, other and more sophisticated ultrasound based plaque characteristics (such as grey scale median, entropy, coarseness, juxtaluminal hypoechoic black area) were not shown to be beneficial in predicting plaque vulnerability (study III). Contrast enhanced ultrasound technic tested in study IV did not improve quantification of atherosclerotic plaque burden. 

    Conclusion: Medical ultrasound technology by using a automatically measure of carotid intima media thickness can be used with high reproducibility and also possible to be transferred to primary care by a well designed training program.  Plaque characteristic using carotid ultrasound was not found to be useful in risk stratifying symptomatic patients with severe carotid stenosis. Furthermore, contrast enhanced ultrasound technique was found to have high reproducibility in plaque area assessment but not better than conventional b-mode based method in quantifying the atherosclerotic burden. Therefore, more sophisticated ultrasound based methods for assessment plaque characteristics was not found to be beneficial in predicting plaque vulnerability.

  • 9. Vanoli, Davide
    et al.
    Backman, Christer
    Holmgren, Anders
    Inferior infarction complicated by ruptured interventricular septum2015Ingår i: International Cardiovascular Forum Journal, ISSN 2410-2636, Vol. 2, nr 1, s. 44-45Artikel i tidskrift (Refereegranskat)
  • 10.
    Vanoli, Davide
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Grönlund, C.
    Näslund, U.
    Wiklund, U.
    Johansson, E.
    Wester, P.
    Lindqvist, P.
    Ultrasound-based plaque texture characteristics are not useful in risk stratification in patients with symptomatic carotid stenosis waiting for carotid surgeryManuskript (preprint) (Övrigt vetenskapligt)
  • 11.
    Vanoli, Davide
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Lindqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Plaque characterisation and analysis in the risk stratifying patients with symptomatic carotis stenosis2016Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 252, s. E191-E191Artikel i tidskrift (Övrigt vetenskapligt)
  • 12.
    Vanoli, Davide
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Lindqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Wiklund, Urban
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Henein, Michael
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Näslund, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Fully automated on-screen carotid intima-media thickness measurement: a screening tool for subclinical atherosclerosis2013Ingår i: Journal of Clinical Ultrasound, ISSN 0091-2751, E-ISSN 1097-0096, Vol. 41, nr 6, s. 333-339Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose Carotid intima-media thickness (CIMT) is generally considered an appropriate direct vascular method for cardiovascular risk assessment. The objective of this study was to evaluate the feasibility and reproducibility of a newly developed automated on-screen carotid ultrasound with respect to manual measurement with a conventional system.

    Methods We assessed CIMT in 50 consecutive patients (age 62 +/- 5 years, range 21-79 years, 36 men) twice, using a newly developed automated ultrasound (CardioHealth Station) and a conventional system with manual measurement (Acuson, Sequoia). For each patient, three frozen frames of the distal 10 mm of the right and left common carotid arteries were acquired on the two systems, by operators blinded to each other. The average of the mean value of three readings of each system was calculated.

    Results The intraclass correlation coefficient of the interoperator variability was 0.95 and 0.94 for the automated and manual measurements, respectively. The comparative coefficient of variation of the interoperator variability was 8.2 and 8.7% for the automated and manual measurements, respectively. There was no clinically relevant difference between measurements obtained by the two systems (intraclass correlation coefficient=0.98). The acquisition time of the automated system was significantly shorter than the conventional system (p<0.01).

    Conclusions Fully automated on-screen measurements of CIMT are feasible, faster, and as reproducible as conventional manual measurements and may be suitable and cost-effective for screening application in community medicine.

  • 13.
    Vanoli, Davide
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Nyman, E.
    Wiklund, U.
    Näslund, U.
    Lindqvist, P.
    Quantification of atherosclerotic plaque area by vascular ultrasound: reproducibility and comparison between conventional B-mode imaging and contrast-enhanced ultrasoundManuskript (preprint) (Övrigt vetenskapligt)
  • 14.
    Vanoli, Davide
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Wiklund, Urban
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Lindqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
    Henein, Michael
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Näslund, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Successful novice's training in obtaining accurate assessment of carotid IMT using an automated ultrasound system2014Ingår i: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 15, nr 6, s. 637-642Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims The aim of this study was to assess the feasibility and learning curve of training novice operators in using automated ultrasound to achieve satisfactory carotid intima-media thickness (CIMT) measurements.

    Methods and results Four novices underwent 4 weeks carotid ultrasound training using a newly developed automated ultrasonograph. A longitudinal B-mode image of the distal right common carotid artery (CCA) was acquired in 96 patients. The interoperator CIMT reproducibility was analysed by the coefficient of variation (CV) and intraclass correlation coefficient (ICC) for every week and compared with that from an expert operator. The weekly mean CV of the measurements on the 24 patients made by all novices was consistently reduced: 0.06, 0.05, 0.03, and 0.02, respectively. For the expert, the mean CV was 0.02, 0.02, 0.03, and 0.02, respectively. The novices' standard deviation (SD) of CVs also reduced weekly from 0.04 in the first week to 0.01 in the last week (P < 0.05). The corresponding weekly variation in the SD for the expert was 0.02 for the first week to 0.01 in the last week (P = 0.27). The agreement between measurements made by the novices was expressed by the ICC being 0.97 (P < 0.001) in the first week and increased to 0.99 (P < 0.001) in the fourth week.

    Conclusion CIMT assessment by novices using an automated ultrasound could be reliably achievable after a short training period. These results may have encouraging implications when designing screening programmes for primary prevention in community health service.

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