EACVI survey on the evaluation of quality echocardiographic examination

This survey, conducted by the EACVI Scientific Initiatives Committee, is to evaluate the quality of echocardiographic examination across different European centres in the EACVI survey network. These results will provide a framework for echocardiographic quality assessment and define specific criteria for quality measures.

May we remind you of the codes of conduct related to market research among healthcare professionals:
· The survey is anonymous
· You have the right to end your participation in this survey at any time
· We comply with the European General Data Protection Regulation (GDPR) 2016/679. Any personal data processed in connection with this survey will be treated confidentially and only used for the purposes of market research. Material and data collected from you will be analysed overall, used internally by the ESC and kept for a maximum of 24 months for analysis and quality control purposes. We take all reasonable care to prevent any unauthorised access to your personal data. We respect your privacy and your right to access, modify, or suppress your personal data. At any time, you can ask to know what personal data is being held. If you have any questions about data protection or require further information, please contact our data protection officer DPO@escardio.org

1.May we please ask you to confirm you have read the clauses above and accept participation in this survey?

Yes

2.Which country do you work in?

5.What is your subspecialty?

Echocardiography (dedicated daily practice in Echo lab; advanced echo studies performed e.g. stress echo, TEE, 3D or speckle tracking modalities performed routinely)

Multimodality cardiovascular imaging

General cardiology (with routine use of cardiac ultrasound)

Other cardiology subspeciality (interventional, heart failure, EP specialist...) with routine use of cardiac ultrasound

6.Do you have EACVI (or other mutually recognised international) TTE or TEE certification?

Yes

No, I have the national TTE/TEE certification

No (without National certification; non-existing)

No, I am certified in another modality (CT, CMR or nuclear certification)

7.Are you working in an echocardiographic lab which has EACVI accreditation?

Yes

8.Who performs the transthoracic echo exams in your lab?
Select all that apply.

9.Do you use either the list of indications (Appropriate Use Criteria) or any national or lab-specific triage recommendations to determine whether the indication for echocardiography is appropriate?

Yes

10.Do you regularly use a minimal standard imaging acquisition protocol for echocardiography recommended by EACVI or your national imaging society (minimum required cine-loops and still frames that should be obtained in every patient)?

Yes

11.Which parameters do you regularly document in the echocardiographic report?
Select all that apply.

Blood pressure at the time of the examination

Heart rhythm and heart rate at the time of examination

Patient height and weight (for calculation of BMI and BSA)

Reason (indication) of the echo examination

Prior medical history

Vendor

Image quality

12.Do you regularly connect ECG to your echocardiographic examinations?

Yes

13.Do you use predefined standard echocardiographic and Doppler measurements which should be reported in every echocardiographic exam (recommended by EACVI or national imaging society)?

Yes

14.Do you regularly report the standard measurements of the size of all four cardiac chambers (LV volumes, RV diameter and atrial volumes) and great vessels in the echocardiographic report?

Yes, if image quality is sufficient for measurements.

Only if these are abnormal

15.Do you regularly report the quantitative measurements of valve pathology in the echocardiographic report (e.g. EROA, regurgitant volume, regurgitant fraction for regurgitant lesion, and valve area, pressure gradients for stenosis lesion)?

Yes, if the image quality is sufficient for measurements

Only in significant valvular pathologies

16.Which of the following statements BEST describes the method of assessment of the LV systolic function in your lab?

In all studies ejection fraction (EF) is measured via biplane Simpson method (and/or 3D (semi)automatic method)

In most studies EF is measured via biplane Simpson method (and/or 3D (semi)automatic method)

In all studies EF is estimated visually (eyeball method)

In most studies EF is estimated visually (eyeball method)

EF is assessed (by any method) only if it looks reduced

17.Which of the following statements BEST describes the method of assessing LV diastolic function in your lab?

In all studies multiparametric approach (mitral inflow velocities, tissue Doppler velocities, tricuspid regurgitation velocities, LA volume index) is used

In most of the studies multiparametric approach is used

Besides the multiparametric approach, additional parameters (e.g.LA strain, pulmonary vein flow…) are regularly used

In all studies only a few parameters from multiparametric approach are used

In most studies only a few parameters from multiparametric approach are used

Diastolic function is not regularly assessed

18.Do you regularly perform LV strain analysis in clinical echocardiographic examination?

Yes, if image quality is sufficient for measurements

Only for patients with risk for cardiotoxicity

Only in pathologies where the strain has added value

No, although I have a software for strain analysis

No, I do not have software for strain analysis

Other (please specify)

19.Do you regularly perform RV or/and LA strain analysis in clinical echocardiographic examination?

Yes, if image quality is sufficient for measurements

Only for patients with risk for cardiotoxicity

Only in pathologies where the strain has added value (e.g. LA strain for diastolic dysfunction assessment)

Other (please specify)

20.Do you regularly perform 3D echocardiography in clinical echocardiographic examination (for cardiac chamber volume and function assessment and/or for assessment of valve pathology)?

Yes, if image quality is sufficient for measurements

Only when doubts on the chamber dimension and function or valve pathology

No, although I have 3D probe

No, I do not have 3D probe

21.Do you regularly use contrast for left ventricular opacification in case of not optimal image quality?

Yes

Only for LV thrombus detection

Only if the results affect clinical decision-making and the image quality is inadequate for reliable endocardial border definition

22.Does your echocardiographic report regularly consist of the conclusion that shall answer to the clinical query posed by the referring physician and compare the results with prior available echo exams?

Conclusion replies to the clinical query and compares with prior results if available

Conclusion replies to the clinical query only, without comparing with previous results

Conclusion emphasises only significant pathology and compares with prior results if available

Conclusion emphasised only significant pathology, without comparing with prior results

There is no conclusion in echo report

23.Do you record and digitally store all echocardiographic exams available for subsequent retrieval and review?

Yes

Only interesting cases

24.Do you have regular (e.g. weekly) meetings to discuss complex or interesting cases in the echo lab?

Yes

I am not a member of the echocardiographic lab

25.Which of the following quality control measures for echocardiographic studies are routinely performed in your laboratory?
Select all that apply.

Reviewing the adherence to standard acquisition protocol

Reviewing the image interpretation

Assessing observer variability for measurements

Assessing limits of agreement of echo LV volumes and cardiac MR

Relation of stress echo result with other imaging stress study and/or ensuing coronary angiogram

Quality control is not performed in my echocardiographic lab

26.Do you routinely request informed consent for stress echo or TEE studies?