The interpretation of hepatic venous pressure gradient tracings - excellent interobserver agreement unrelated to experience

Liver International : Official Journal of the International Association for the Study of the Liver
Puneeta TandonGuadalupe Garcia-Tsao

Abstract

The hepatic venous pressure gradient (HVPG) plays an important role in the diagnosis, prognosis and therapy of patients with cirrhosis and portal hypertension. One barrier to its widespread use is the potential for a low reproducibility. We aimed to evaluate the interobserver agreement in the interpretation of optimally acquired HVPG tracings from patients with cirrhosis and different degrees of portal hypertension. Two hundred and fifteen tracings obtained from 51 patients with cirrhosis in a single centre were interpreted independently by two hepatologists: one experienced observer and one inexperienced observer. Correlation was performed by Pearson linear regression and the intraclass correlation coefficient (ICC). A Bland-Altman plot was constructed to visualize how the differences between observers compared across the range of measurements. Logistic regression was used to identify predictors of ≥10% variation between observers' readings. There was a significant linear relationship between observers' readings r = 0.98 (P = 0.001). The ICC between observers (interobserver agreement) was also excellent at 0.991 (P = 0.001). Using the Bland-Altman technique, the mean difference between the observers' readings was 0.2 mmHg (95%...Continue Reading

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Citations

Oct 9, 2016·Liver International : Official Journal of the International Association for the Study of the Liver·R Todd Stravitz, Yaron Ilan
Apr 1, 2017·Hepatology International·Jonathan Chung-Fai LeungVincent Wai-Sun Wong
Jul 21, 2020·Exploration of Medicine·Marvin RyouGyorgy Baffy
Apr 12, 2021·Clinics in Liver Disease·Daniel Veldhuijzen van ZantenJuan G Abraldes
Jun 29, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Wayne BaiJuan G Abraldes

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