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A Unique Model for ONSD Part II: Inter/Intra-operator Variability

Published online by Cambridge University Press:  20 October 2014

F.A. Zeiler ,
B. Unger ,
Q. Zhu ,
J. Xiao ,
A.W. Kirkpatrick ,
A.H. Kramer ,
E.M. Aleassa  and
L.M. Gillman
F.A. Zeiler*
Affiliation:
Section of Neurosurgery, University of Manitoba, Winnipeg, Manitoba Section of Neurocritical Care, Montreal Neurological Institute, Mcgill University, Montreal, Quebec
B. Unger
Affiliation:
Department of Surgery, Department of Medical Education, University of Manitoba, Winnipeg, Manitoba
Q. Zhu
Affiliation:
Regional Trauma Services and Section of General Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
J. Xiao
Affiliation:
Regional Trauma Services and Section of General Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
A.W. Kirkpatrick
Affiliation:
Regional Trauma Services and Section of General Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada Section of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
A.H. Kramer
Affiliation:
Section of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
E.M. Aleassa
Affiliation:
Section of General Surgery, University of Manitoba, Winnipeg, Manitoba
L.M. Gillman
Affiliation:
Section of General Surgery, University of Manitoba, Winnipeg, Manitoba
*
Section of Neurosurgery, Dept of Surgery, University of Manitoba, GB-1 Health Sciences Center, 820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada. Email: umzeiler@cc.umanitoba.ca.
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Abstract

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Objective:

To evauluate our novel ultrasound model for measurement of optic nerve sheath diameter (ONSD) and determine the intra- and inter-operator variability associated with this technique.

Methods:

We conducted ten measurements of ONSD per model amongst eight different models with a single experienced operator to examine intra-operator variability. Similarly, we had seven different operators measure the OSND twice in eight different models, in order to determine inter-operator variability analyzed with a three level linear statistical model.

Results:

For intra-operator variability, the intra-cluster correlation coefficients for the experienced and novice operators were 0.643 and 0.453 respectively. This displayed improvement in intra-operator variability with experience. The inter-cluster correlation coefficient was 0 for the group of novice operators, indicating negligible difference amongst multiple operators in measuring any given model of ONSD. A strong, statistically significant, linear relationship between the actual model disc size and the ultrasound ONSD measures was identified, implying the reliability of the images produced by our novel model.

Conclusions:

Utilizing a novel model for ONSD ultrasonography, we have determined the intraoperator reliability of ONSD measurement to be moderate, with no appreciable difference amongst multiple operators. Improvement in measurement reliability has been demonstrated between expert and novice operators with our model, indicating the potential benefit of simulation platforms for teaching the technique of ONSD ultrasound.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 4 , July 2014 , pp. 430 - 435
Copyright
Copyright © The Canadian Journal of Neurological 2014

References

1.Dubourg, J, Javouhey, E, Geeraerts, T, Messerer, M, Kassai, B.Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2011;37:1059–68.CrossRefGoogle ScholarPubMed
2.Moretti, R, Pizzi, B, Cassini, F, Vivaldi, N.Reliability of optic nerve ultrasound for the evaluation of patients with spontaneous intracranial hemorrhage. Neurocrit Care. 2009;11:406–10.CrossRefGoogle ScholarPubMed
3.Bauerle, J, Lochner, P, Kaps, M, Nedelmann, M.Intra- and interobserver reliability of sonographic assessment of the optic nerve sheath diameter in healthy adults. J Neuroimaging. 2012;22:42–5.CrossRefGoogle ScholarPubMed
4.Ballantyne, SA, O'Neill, G, Hamilton, R, Hollman, AS.Observer variation in the sonographic measurement of optic nerve sheath diameter in normal adults. Eur J Ultrasound. 2002;15:145–9.CrossRefGoogle ScholarPubMed
5.McAuley, D, Paterson, A, Sweeney, L.Optic nerve sheath ultrasound in the assessment of paediatric hydrocephalus. Childs Nerv Syst. 2009;25:87–90.CrossRefGoogle ScholarPubMed
6.Hansen, HC, Helmke, K.Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests. J Neurosurg. 1997;87:34–40.CrossRefGoogle ScholarPubMed
7.Rajajee, V, Fletcher, JJ, Rochlen, LR, Jacobs, TL.Comparison of accuracy of optic nerve ultrasound for the detection of intracranial hypertension in the setting of acutely fluctuating vs stable intracranial pressure: post-hoc analysis of data from a prospective, blinded single center study. Critical Care. 2012;16:R79.CrossRefGoogle ScholarPubMed
8.Zeiler, FA, Unger, B, Kramer, AH, Kirkpatrick, AW, Gillman, LM.A unique model for ultrasound assessment of optic nerve sheath diameter. Can J Neurol Sci. 2013;40(2):225–9.CrossRefGoogle ScholarPubMed
9.Gangemi, M, Cennamo, G, Maiuri, F, D'Andrea, F.Echographic measurement of optic nerve in patients with intracranial hypertension. Neurochirurgia (Stuttg). 1987;30(2):53–5.Google ScholarPubMed
10.Rajajee, V, Vanaman, M, Fletcher, JJ, Jacobs, TL.Optic nerve ultrasound for the detection of raised intracranial pressure. Neurocrit Care. 2011;15(3):506–15.CrossRefGoogle ScholarPubMed
11.Strumwasser, A, Kwan, RO, Yeung, L, et al. Sonographic optic nerve sheath diameter as an estimate of intracranial pressure in adult trauma. J Surg Res. 2011;170(2):265–71.CrossRefGoogle ScholarPubMed
12.Moretti, R, Pizzi, B.Ultrasonography of the optic nerve in neurocritically ill patients. Acta Anaesthesiol Scand. 2011;55(6):644–52.CrossRefGoogle ScholarPubMed
13.Kimberly, HH, Shah, S, Marill, K, Noble, V.Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med. 2008;15(2):201–4.CrossRefGoogle ScholarPubMed