A minimum dataset for a standard adult …

1 guidelines AND RECOMMENDATIONSA minimum dataset for a standard adulttransthoracic echocardiogram : a guidelineprotocol from the British Society ofEchocardiographyGill Wharton*, Richard Steeds1, , Jane Allen, Hollie Phillips2, Richard Jones3,Prathap Kanagala4, Guy Lloyd5, Navroz Masani6, Thomas Mathew7,David Oxborough8, Bushra Rana9, Julie Sandoval10, Richard Wheeler6,Kevin O Gallagher11andVishal Sharma12 York Teaching Hospital NHS Foundation Trust, York, UK1 Queen Elizabeth Hospital, University Hospital Birmingham NHS foundation Trust, Birmingham, UK2 InHealth Ecotech, Hampshire, UK3 Portsmouth Hospitals NHS Trust, Portsmouth, UK4 Glenfield Hospital, Leicester, UK5 Eastbourne District General Hospital.

2 Eastbourne, UK6 University Hospital of Wales, Cardiff, UK7 Nottingham University Hospital, Nottingham, UK8 Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK9 Cardiology Department, Papworth Hospital, Cambridge, UK10 Cardiac Ultrasound, Leeds Teaching Hospitals NHS Trust, Leeds, UK11 King s College Hospital NHS Foundation Trust, London, UK12 Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK*(G Wharton is the lead author) (R Steeds is the guidelines Chair)Correspondenceshould be addressedto V have been significant advances in the field of echocardiography with the introductionof a number of new techniques into standard clinical practice.

3 Consequently, a standard echocardiographic examination has evolved to become a more detailed and time-consumingexamination that requires a high level of expertise. This Guideline produced by the BritishSociety of Echocardiography (BSE) Education Committee aims to provide a minimum datasetthat should be obtained in a comprehensive standard echocardiogram . In addition, thelayout proposes a recommended sequence in which to acquire the images. If abnormalpathology is detected, additional views and measurements should be obtained withreference to other BSE protocols when appropriate. Adherence to these recommendationswill promote an increased quality of echocardiography and facilitate accurate comparison ofstudies performed either by different operators or at different Words"transthoracicechocardiography"2D echocardiography"guidelinesIntroductionT his Guideline aims to provide a framework for perfor-ming an adult transthoracic echocardiogram (TTE)

4 And replaces the previous minimum datasets current Guideline differs from the 2005 dataset inoutlining the views and measures recommended in a fullycomprehensive TTE, and in addition recognises that suchOpenAccessG Wharton and othersMinimum dataset fortransthoracic echoID: 14-0079; March 2015 DOI: work is licensed under aCreative CommonsAttribution-NonCommercial-NoDeriv s The British Society of by Bioscientifica LtdDownloaded from at 11/21/2020 09:18:22 PMvia free accessstudies may not be performed in all circumstances. Thelayout proposes a recommended sequence on how toperform a comprehensive TTE.

5 minimum requirements are depicted in bold text andidentify the views and measurements that should beperformed in all subjects being scanned for the first time recommendations are depicted in italics and togetherwith the minimum requirements form the basis of acomprehensive examination. Wherever possible, a com-prehensive study comprising all the views and measure-ments in this Guideline outlined in black italics and boldfont text should be performed, provided the views andmeasurements can be obtained reliably. It is understoodthat not all the measurements in the minimum require-ments dataset will be performed in all follow-up is also understood that not all measurements in theminimum requirements will be performed in focused ortarget studies, for example check pericardial minimum requirements and recommendationsmay only be sufficient when the echocardiographic studyis entirely normal.

6 If abnormalities are detected,additional views may be required to supplement thoseoutlined in the layout has been altered to provide a visual exampleof the ideal image that should be acquired in each acousticwindow. This is supported by text that follows a standardlayout the acoustic window and transducer position inthe first column, followed by the modality to be used,measurements to be made at that location and anexplanation if additional information is deemed standard adult transthoracicechocardiogram1. Benefits and general principlesA standardised approach to performing an echocardio-gram is extremely important not only to ensure thatpathology is not missed but to facilitate comparisonbetween The intended benefits of this Guideline are: To support cardiologists and echocardiographers todevelop local protocols and quality control programmesfor an adult transthoracic study.

7 These minimumrequirements and recommendations provide a templateagainst which studies in any department should beaudited. To promote quality by defining a minimum dataset ofdescriptive terms and measurements. To promote quality by defining a recommended datasetof descriptive terms and measurements that depart-ments should work toward obtaining in all studies. To facilitate accurate comparison of serial echocardio-grams performed in patients at the same or differentsites. To facilitate the transition to digital echocardiographyacquisition and reporting systems that use database(software) There is broad agreement regarding the standardviews and recordings essential in an echocardiographicexamination.

8 There is, however, no evidence-base andthese recommendations and requirements represent aconsensus view on the components of a complete It is expected that a standard echocardiogramfollowing at least these minimum requirements will beperformed in all adults when an echocardiogram isrequested. This type of study is expected to make up themajority of those performed within any department,whether in the community or in is recognised that focused studies may be appro-priate in some circumstances agreed locally. Focused TTEcan either mean focusing on major abnormalities pre-dominantly in an urgent clinical situation, pericardialeffusion, or focusing on a particular aspect of the heart, longitudinal monitoring of left ventricular skill level required for such studies is very high and itis expected that the patient will previously have had a full- standard TTE before monitoring commences or after anemergency assessment has been completed.

9 Such studiesshould be clearly identified as focused studies and are notcovered by this When the condition or acoustic windows of thepatient prevent the acquisition of one or more com-ponents of the minimum dataset , or when measurementsresult in misleading information ( off-axis measure-ments) this should be is recommended that any study is accompanied bya statement regarding the image quality achieved: good/ Unless the physical condition of the patient preventstransfer, all TTEs should be performed in a suitableenvironment, with optimal facilities to obtain the highestquality ultrasound images, including lighting, space andimaging couches, whilst guaranteeing patient Wharton and othersMinimum dataset fortransthoracic echoID: 14-0079.

10 March 2015 DOI: from at 11/21/2020 09:18:22 PMvia free accessThese facilities demand except in exceptional circum-stances that echocardiography is delivered in anappropriately equipped department that satisfies therequirements of the BSE Departmental Accreditationprocess. This ensures optimum conditions for a detailedstudy, reduces the risk of musculoskeletal disordersfor echocardiographers ( ), and may reduce the risk ofhospital-acquired infection. When portable echocardio-graphy has to be performed at the bedside, the require-ments of the minimum dataset must be Identifying informationThe images acquired should be clearly labelled withpatient identifiers, including the following: Patient name.