A Unique Method for Estimating the Reliability Learning Curve of Optic Nerve Sheath Diameter Ultrasound Measurement

Overview

Journal Crit Ultrasound J

Specialty Critical Care

Date 2016 Aug 10

PMID 27501699

Citations 13

Authors

Frederick A Zeiler

Markus T Ziesmann

Patrick Goeres

Bertram Unger

Jason Park

Dimitrios Karakitsos

Michael Blaivas

Ashley Vergis

Lawrence M Gillman

Affiliations

Soon will be listed here.

Abstract

Background: Optic nerve sheath diameter (ONSD) measurement using ultrasound has been proposed as a rapid, non-invasive, point of care technique to estimate intra-cranial pressure (ICP). Ultrasonic measurement of the optic nerve sheath can be quite challenging and there is limited literature surrounding learning curves for this technique. We attempted to develop a method to estimate the reliability learning curve for ONSD measurement utilizing a unique definition of reliability: a plateau in within-subject variability with unchanged between-subject variability.

Methods: As part of a previously published study, a single operator measured the ONSD in 120 healthy volunteers over a 6-month period. Utilizing the assumption that the four measurements made on each subject during this study should be equal, the relationship of within-subject variance was described using a quadratic-plateau model as assessed by segmental polynomial (knot) regression.

Results: Segmental polynomial (knot) regression revealed a plateau in within-subject variance after the 21st subject. However, there was no difference in overall mean values [3.69 vs 3.68 mm (p = 0.884)] or between-subject variance [14.49 vs 11.92 (p = 0.54)] above or below this cutoff.

Conclusions: This study suggests a significant finite learning curve associated with ONSD measurements. It also offers a unique method of calculating the learning curve associated with ONSD measurement.

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