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Diagnosis of patent ductus arteriosus by a neonatologist

Journal of Perinatology volume 27, pages 734–735 (2007)Cite this article

We read with interest the paper by Lee et al. assessing a neonatologist's accuracy in diagnosing patent ductus arteriosus (PDA) using compact, portable ultrasound after limited training.1 The neonatololgist's study exams were compared to the routine scheduled echocardiograms performed on the same patients by the pediatric cardiology service. We have a few questions and comments to add regarding this study.

The study and routine exams were recorded on electronic media and later reviewed in a masked fashion by a cardiologist who was not familiar with the patients in the study. Was the masked reviewing cardiologist aware of the study design? There are two factors that potentially unmasked this study: (1) the neonatologist used an Acuson Cypress (Siemens USA, Malvern, PA, USA) and the pediatric cardiologists used an Acuson Sequoia (Siemens USA). Both the viewable screen and the difference in image quality may have alerted the reviewing cardiologist and biased their report and (2) the neonatologist performed a partial study and the cardiologist performed a complete study, again alerting the reviewing cardiologist to a different protocol. Since it may be more practical for institutions without consistent on-site cardiologist availability to have a more affordable ultrasound machine, such as the Acuson Cypress, diagnosis of PDA using this machine by both the pediatric cardiologist and the neonatologist may have provided more insight into the variance in the ability to diagnose PDA accurately, as well as demonstrating any limitations of a less advanced ultrasound machine even if used in the expert hands of a member of the pediatric cardiology service.

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References

  1. Lee HC, Silverman N, Hintz SR . Diagnosis of patent ductus arteriosus by a neonatologist with a compact, portable ultrasound machine. J Perinatol 2007; 27: 291–296.

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  2. Attridge JT, Clark R, Walker MW, Gordon PV . New insights into spontaneous intestinal perforation using a national data set: (1) SIP is associated with early indomethacin exposure. J Perinatol 2006; 26: 93–99.

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Authors and Affiliations

  1. Department of Neonatology, US Naval Hospital Okinawa and 18th Medical Group, Kadena Air Base, Okinawa, Japan

    R M McAdams

  2. Division of Cardiology, Department of Pediatrics, Wilford Hall Medical Center, San Antonio, TX, USA

    K A Milhoan

Authors
  1. R M McAdams
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  2. K A Milhoan
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Correspondence to R M McAdams.

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The opinions expressed in this paper are solely those of the authors and do not represent the views of the United States Air Force, United States Navy, Department of Defense or the United States Government.

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McAdams, R., Milhoan, K. Diagnosis of patent ductus arteriosus by a neonatologist. J Perinatol 27, 734–735 (2007). https://doi.org/10.1038/sj.jp.7211813

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