Key result
The use of TAVIApp by young cardiology residents improved concordance with expert evaluations for aortic stenosis diagnosis and eligibility assessment from k=0.52 to k=1.0 (p<0.001).
Why the study?
Does TAVIApp improve the concordance of young cardiology residents with expert Heart Teams in the management of aortic stenosis?
Cross-Sectional (n=42)
Blinded
Does TAVIApp improve the concordance of young cardiology residents with expert Heart Teams in the management of aortic stenosis?
TAVIApp significantly improves the accuracy of young cardiology residents in diagnosing severe AS and selecting appropriate TAVI prosthesis sizes, achieving perfect concordance with expert Heart Team consensus.
May aid resident TAVI planning but should not change practice; hypothesis-generating and requires prospective validation.
Background. Aortic stenosis (AS) is the most common heart valve disease in developed countries. The advent of transcatheter aortic valve implantation (TAVI) significantly improved patients’ outcome but made clinical management more complex. The aim of the present study was to describe TAVIApp, a mobile app we developed to guide the management of AS, and test its efficacy. Methods and Results. Clinical cases comprising 42 patients with AS were blindly evaluated by (A) an interventional cardiologist, assisted by the Heart Team (EXPERT), (B) young residents in cardiology, and (C) a young resident supported by TAVIApp. There was poor concordance between Group A and Group B with low performance by young residents ( k=0.52 ; p<0.001 ). However, concordance increased to an optimal value when young residents were supported by TAVIApp ( k=1.0 ; p<0.001 ) for the diagnosis of severe AS and eligibility assessment. Furthermore, regarding the selection of the most appropriate prosthesis size, concordance to Group A was poor without TAVIApp support (Group B) ( k=0.78 ; p=0.430 ), but excellent with TAVIApp ( k=1.0 ; p<0.001 ). Conclusions. This study is the first describing and validating a new mobile application to support the management of AS. TAVIApp supports cardiologists in the evaluation of stenosis severity, eligibility for TAVI or AVR, and selection of the most appropriate prosthesis size in individual patients.
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Indolfi et al. (2017) conducted a cross-sectional in Aortic stenosis (n=42). TAVIApp vs. Evaluation without TAVIApp was evaluated on Concordance with expert evaluation for diagnosis of severe AS and eligibility assessment (p=<0.001). The use of TAVIApp by young cardiology residents improved concordance with expert evaluations for aortic stenosis diagnosis and eligibility assessment from k=0.52 to k=1.0 (p<0.001).
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