A statistical comparison of reproducibility in current pediatric two-dimensional echocardiographic nomograms

• Published in: Pediatric research Vol. 89; no. 3; pp. 579 - 590
• Main Authors: Cantinotti, Massimiliano, Scalese, Marco, Giordano, Raffaele, Assanta, Nadia, Marchese, Pietro, Franchi, Eliana, Viacava, Cecilia, Koestenberger, Martin, Jani, Vivek, Kutty, Shelby
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.02.2021; Nature Publishing Group
• Subjects: Adolescent; Child; Child, Preschool; Clinical Research Article; Coronary Vessels - physiology; Decision Making; Echocardiography - methods; Female; Humans; Infant; Infant, Newborn; Italy; Linear Models; Male; Medicine; Medicine & Public Health; Mitral Valve - physiology; Models, Statistical; Multivariate Analysis; Nomograms; Nonlinear Dynamics; Pediatric Surgery; Pediatrics; Reference Values; Reproducibility; Reproducibility of Results; Retrospective Studies; Tricuspid Valve - physiology; United States; Young Adult; United States; Italy
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1038/s41390-020-0900-z

Background The aim of this study is to compare new pediatric nomograms for clinical parameters from 2D echocardiography. Methods 2D pediatric echocardiographic parameters from four recent nomograms were used for statistical analysis. To assess the accuracy of the predictive models from each study, namely multivariate, linear, and nonlinear regression, mean values and 5th and 95th percentiles ( μ  ± 1.65 σ ) were calculated. A Z -score calculator was created. Results Mean values and 5th and 95th percentiles have been provided for a range of BSA (0.15−2.20 m 2 ) for each nomogram assessed in this study. Moreover, plots of Z-scores over the same range of BSA have been generated to assess trends among different studies. For most measurements from the two most recent nomograms, namely Lopez et al. and Cantinotti et al., differences were within a Z -score of 0.5 ( Z -score range: 0.001−1.26). Measurements from Sluysmans and Colan and Pettersen et al. were observed to diverge from Lopez et al. at the upper extremities of BSA. Differences among various nomograms emerged at lower extremes of BSA. Conclusions The two most recent echocardiographic nomograms were observed to have the most statistically similar ranges of normality. Significant deviations in ranges of normality were observed at extremes of BSA. Impact Echocardiographic nomograms for pediatric age are discordant. Comparison of current pediatric echocardiographic nomograms. A Z -score calculator was created. Clinical relevance of differences among nomograms is highlighted.