{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T18:33:18Z","timestamp":1758479598461,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005627","name":"Thrasher Research Fund","doi-asserted-by":"publisher","award":["13908"],"award-info":[{"award-number":["13908"]}],"id":[{"id":"10.13039\/100005627","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2022,11,14]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Screening programmes using echocardiography offer opportunity for intervention through identification and treatment of early (latent) rheumatic heart disease (RHD). We aimed to compare two methods for classifying progression or regression of latent RHD: serial review method and blinded, side-by-side review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A four-member expert panel reviewed 799 enrolment (in 2018) and completion (in 2020) echocardiograms from the GOAL Trial of latent RHD in Uganda to make consensus determination of normal, borderline RHD or definite RHD. Serial interpretations (enrolment and completion echocardiograms read at two different time points, 2\u2009years apart, not beside one another) were compared with blinded side-by-side comparisons (enrolment and completion echocardiograms displayed beside one another in random order on same screen) to determine outcomes according to prespecified definitions of disease progression (worsening), regression (improving) or no change. We calculated inter-rater agreement using Cohen\u2019s kappa.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 799 pairs of echocardiogram assessments included. A higher number, 54 vs 38 (6.8% vs 4.5%), were deemed as progression by serial interpretation compared with side-by-side comparison. There was good inter-rater agreement between the serial interpretation and side-by-side comparison methods (kappa 0.89). Disagreement was most often a result of the difference in classification between borderline RHD and mild definite RHD. Most discrepancies between interpretation methods (46 of 47, 98%) resulted from differences in valvular morphological evaluation, with valves judged to be morphologically similar between enrolment and final echocardiograms when compared side by side but classified differently on serial interpretation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There was good agreement between the methods of serial and side-by-side interpretation of echocardiograms for change over time, using the World Heart Federation criteria. Side-by-side interpretation has higher specificity for change, with fewer differences in the interpretation of valvular morphology, as compared with serial interpretation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2022-002160","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T13:59:11Z","timestamp":1669903151000},"page":"e002160","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of approaches to determine echocardiographic outcomes for children with latent rheumatic heart disease"],"prefix":"10.1136","volume":"9","author":[{"given":"Joselyn","family":"Rwebembera","sequence":"first","affiliation":[{"name":"Cardiology, Uganda Heart Institute Ltd, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Beaton","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6109-0092","authenticated-orcid":false,"given":"Emmy","family":"Okello","sequence":"additional","affiliation":[{"name":"Cardiology, Uganda Heart Institute Ltd, Kampala, Uganda"},{"name":"Mulago National Referral Hospital, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Engelman","sequence":"additional","affiliation":[{"name":"Centre for International Child Heath, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia"},{"name":"Group A Streptococcal Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ndate","family":"Fall","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Mirabel","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center PARCC, Universit\u00e9 de Paris 1, Paris, France"},{"name":"Cardio-oncology Unit, H\u00f4pital Europ\u00e9en Georges Pompidou Chirurgie cardio vasculaire, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Nakitto","sequence":"additional","affiliation":[{"name":"Uganda Heart Institute Ltd, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Carmo","family":"Pereira Nunes","sequence":"additional","affiliation":[{"name":"Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7955-3481","authenticated-orcid":false,"given":"Jafesi","family":"Pulle","sequence":"additional","affiliation":[{"name":"Cardiology, Uganda Heart Institute Ltd, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Sarnacki","sequence":"additional","affiliation":[{"name":"Children's National Medical Center, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Scheel","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia Pediatrics Residency Program, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liesl","family":"Zuhlke","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology, University of Cape Town, Rondebosch, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anneke","family":"Grobler","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Parkville, Victoria, Australia"},{"name":"Department of Pediatrics, University of Melbourne VCCC, Parkville, Victoria, 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