Agreement of an echocardiogram-based diagnosis of pulmonary hypertension in infants at risk for bronchopulmonary dysplasia among masked reviewers

Objectiveto evaluate the agreement of an echocardiogram-based pulmonary hypertension diagnosis in premature infants at risk for bronchopulmonary dysplasia (bpd).study designechocardiograms from infants born ≤28 weeks post menstrual age were retrospectively reviewed with a standardized reading protocol by three pediatric cardiologists masked to patient’s clinical history to determine the presence of pulmonary hypertension.resultsa total of 483 echocardiograms from 49 unique patients were each reviewed by three pediatric cardiologists. overall there was an 82.9% agreement on the presence of pulmonary hypertension among the three readers (95% ci: 78.4%, 85.4%) with a modified fleiss’ kappa of 0.759 (95% ci: 0.711, 0.801). percent agreement between rereads was 92.4%, and modified fleiss’ kappa was 0.847 (95% ci: 0.750, 0.931).conclusionsusing a standardized reading protocol and echocardiogram-based definition of pulmonary hypertension, there is high inter- and intra-rater agreement for the diagnosis of pulmonary hypertension in at-risk premature infants, suggesting echocardiography can be successfully used for clinical and research monitoring of pulmonary hypertension in infants.