Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery

Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Franssen, Ruud F. W. [verfasserIn] Eversdijk, Anne J. J. Kuikhoven, Mayella Klaase, Joost M. Vogelaar, F. Jeroen Janssen-Heijnen, Maryska L. G. Bongers, Bart C.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Exercise testing Preoperative risk assessment Prehabilitation Abdominal surgery Preoperative evaluation

Anmerkung:	© The Author(s) 2022

Übergeordnetes Werk:	Enthalten in: BMC anesthesiology - [S.l.] : BioMed Central, 2001, 22(2022), 1 vom: 30. Apr.
Übergeordnetes Werk:	volume:22 ; year:2022 ; number:1 ; day:30 ; month:04

Links:	Volltext

DOI / URN:	10.1186/s12871-022-01680-y

Katalog-ID:	SPR050679171

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100	1		\|a Franssen, Ruud F. W. \|e verfasserin \|4 aut
245	1	0	\|a Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery
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520			\|a Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable.
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allfields	10.1186/s12871-022-01680-y doi (DE-627)SPR050679171 (SPR)s12871-022-01680-y-e DE-627 ger DE-627 rakwb eng Franssen, Ruud F. W. verfasserin aut Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. Exercise testing (dpeaa)DE-He213 Preoperative risk assessment (dpeaa)DE-He213 Prehabilitation (dpeaa)DE-He213 Abdominal surgery (dpeaa)DE-He213 Preoperative evaluation (dpeaa)DE-He213 Eversdijk, Anne J. J. aut Kuikhoven, Mayella aut Klaase, Joost M. aut Vogelaar, F. Jeroen aut Janssen-Heijnen, Maryska L. G. aut Bongers, Bart C. aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 22(2022), 1 vom: 30. Apr. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:22 year:2022 number:1 day:30 month:04 https://dx.doi.org/10.1186/s12871-022-01680-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 30 04
spelling	10.1186/s12871-022-01680-y doi (DE-627)SPR050679171 (SPR)s12871-022-01680-y-e DE-627 ger DE-627 rakwb eng Franssen, Ruud F. W. verfasserin aut Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. Exercise testing (dpeaa)DE-He213 Preoperative risk assessment (dpeaa)DE-He213 Prehabilitation (dpeaa)DE-He213 Abdominal surgery (dpeaa)DE-He213 Preoperative evaluation (dpeaa)DE-He213 Eversdijk, Anne J. J. aut Kuikhoven, Mayella aut Klaase, Joost M. aut Vogelaar, F. Jeroen aut Janssen-Heijnen, Maryska L. G. aut Bongers, Bart C. aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 22(2022), 1 vom: 30. Apr. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:22 year:2022 number:1 day:30 month:04 https://dx.doi.org/10.1186/s12871-022-01680-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 30 04
allfields_unstemmed	10.1186/s12871-022-01680-y doi (DE-627)SPR050679171 (SPR)s12871-022-01680-y-e DE-627 ger DE-627 rakwb eng Franssen, Ruud F. W. verfasserin aut Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. Exercise testing (dpeaa)DE-He213 Preoperative risk assessment (dpeaa)DE-He213 Prehabilitation (dpeaa)DE-He213 Abdominal surgery (dpeaa)DE-He213 Preoperative evaluation (dpeaa)DE-He213 Eversdijk, Anne J. J. aut Kuikhoven, Mayella aut Klaase, Joost M. aut Vogelaar, F. Jeroen aut Janssen-Heijnen, Maryska L. G. aut Bongers, Bart C. aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 22(2022), 1 vom: 30. Apr. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:22 year:2022 number:1 day:30 month:04 https://dx.doi.org/10.1186/s12871-022-01680-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 30 04
allfieldsGer	10.1186/s12871-022-01680-y doi (DE-627)SPR050679171 (SPR)s12871-022-01680-y-e DE-627 ger DE-627 rakwb eng Franssen, Ruud F. W. verfasserin aut Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. Exercise testing (dpeaa)DE-He213 Preoperative risk assessment (dpeaa)DE-He213 Prehabilitation (dpeaa)DE-He213 Abdominal surgery (dpeaa)DE-He213 Preoperative evaluation (dpeaa)DE-He213 Eversdijk, Anne J. J. aut Kuikhoven, Mayella aut Klaase, Joost M. aut Vogelaar, F. Jeroen aut Janssen-Heijnen, Maryska L. G. aut Bongers, Bart C. aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 22(2022), 1 vom: 30. Apr. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:22 year:2022 number:1 day:30 month:04 https://dx.doi.org/10.1186/s12871-022-01680-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 30 04
allfieldsSound	10.1186/s12871-022-01680-y doi (DE-627)SPR050679171 (SPR)s12871-022-01680-y-e DE-627 ger DE-627 rakwb eng Franssen, Ruud F. W. verfasserin aut Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. Exercise testing (dpeaa)DE-He213 Preoperative risk assessment (dpeaa)DE-He213 Prehabilitation (dpeaa)DE-He213 Abdominal surgery (dpeaa)DE-He213 Preoperative evaluation (dpeaa)DE-He213 Eversdijk, Anne J. J. aut Kuikhoven, Mayella aut Klaase, Joost M. aut Vogelaar, F. Jeroen aut Janssen-Heijnen, Maryska L. G. aut Bongers, Bart C. aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 22(2022), 1 vom: 30. Apr. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:22 year:2022 number:1 day:30 month:04 https://dx.doi.org/10.1186/s12871-022-01680-y kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2022 1 30 04
language	English
source	Enthalten in BMC anesthesiology 22(2022), 1 vom: 30. Apr. volume:22 year:2022 number:1 day:30 month:04
sourceStr	Enthalten in BMC anesthesiology 22(2022), 1 vom: 30. Apr. volume:22 year:2022 number:1 day:30 month:04
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Exercise testing Preoperative risk assessment Prehabilitation Abdominal surgery Preoperative evaluation
isfreeaccess_bool	true
container_title	BMC anesthesiology
authorswithroles_txt_mv	Franssen, Ruud F. W. @@aut@@ Eversdijk, Anne J. J. @@aut@@ Kuikhoven, Mayella @@aut@@ Klaase, Joost M. @@aut@@ Vogelaar, F. Jeroen @@aut@@ Janssen-Heijnen, Maryska L. G. @@aut@@ Bongers, Bart C. @@aut@@
publishDateDaySort_date	2022-04-30T00:00:00Z
hierarchy_top_id	355422115
id	SPR050679171
language_de	englisch
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W.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2022</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s) 2022</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Exercise testing</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Preoperative risk assessment</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Prehabilitation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Abdominal surgery</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Preoperative evaluation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Eversdijk, Anne J. 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author	Franssen, Ruud F. W.
spellingShingle	Franssen, Ruud F. W. misc Exercise testing misc Preoperative risk assessment misc Prehabilitation misc Abdominal surgery misc Preoperative evaluation Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery
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topic_title	Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery Exercise testing (dpeaa)DE-He213 Preoperative risk assessment (dpeaa)DE-He213 Prehabilitation (dpeaa)DE-He213 Abdominal surgery (dpeaa)DE-He213 Preoperative evaluation (dpeaa)DE-He213
topic	misc Exercise testing misc Preoperative risk assessment misc Prehabilitation misc Abdominal surgery misc Preoperative evaluation
topic_unstemmed	misc Exercise testing misc Preoperative risk assessment misc Prehabilitation misc Abdominal surgery misc Preoperative evaluation
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title	Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery
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title_full	Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery
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author_browse	Franssen, Ruud F. W. Eversdijk, Anne J. J. Kuikhoven, Mayella Klaase, Joost M. Vogelaar, F. Jeroen Janssen-Heijnen, Maryska L. G. Bongers, Bart C.
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title_sort	inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery
title_auth	Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery
abstract	Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. © The Author(s) 2022
abstractGer	Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. © The Author(s) 2022
abstract_unstemmed	Background Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach. Methods Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇$ O_{2VAT} $) and at peak exercise (V̇$ O_{2peak} $), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇$ CO_{2} $-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient. Results Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇$ O_{2VAT} $, 0.98 (95% CI 0.95–0.99) for V̇$ O_{2peak} $, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇$ CO_{2} $-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇$ O_{2VAT} $, 0.99 (95% CI 0.99–1.00) for V̇$ O_{2peak} $, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇$ CO_{2} $-slope, and 0.98 (95% CI 0.96–0.99) for the OUES. Conclusions Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇$ CO_{2} $-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇$ O_{2VAT} $ and V̇$ O_{2peak} $ are not determinable. © The Author(s) 2022
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title_short	Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery
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Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery

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