VISUAL ESTIMATION OF EJECTION FRACTION BY 2-DIMENSIONAL ECHOCARDIOGRAPHY - THE LEARNING-CURVE

Our purpose was to determine the learning curve of visual estimation o f ejection fraction (EF) by echocardiography. Sixty consecutive patien ts, who had clinically indicated echocardiography and radionuclide ven triculography (RVG) within 1 month were selected. Five standard views were reviewed independently by a first-year cardiology fellow, a priva te cardiologist, and an experienced echocardiographer. Observers were given feedback of the RVG EFs immediately after estimating the EF on e ach study. To assess the effect of learning, the echocardiographic stu dies were divided into three groups of 20 and were read successively b y each observer A statistical comparison of the two methods was perfor med for each group. The correlation between the two techniques for the first group of studies was marginal. There was a significant improvem ent in the correlation with subsequent groups. The correlation did not change significantly with the last group of studies compared with the second group. In conclusion, visual estimation of EF by two-dimension al echocardiography can be learned, with a learning curve of approxima tely 20 studies if immediate feed-back is available.