Evaluation of compatibility between emergency physicians and cardiologists in measuring pulmonary artery pressure, a prospective, observational study

Objective: To evaluate the degree of agreement between emergency physicians (EP) and cardiologists in measuring pulmonary arterial pressure(PAP) (measurement with simplified Bernoulli equation).
Materials and methods: This prospective observational study was conducted between January 2020 and January 2022 in the Emergency Clinic of Antalya Training and Research Hospital, a tertiary hospital. Sample Size calculation: According to Kappa (2 raters) - Hypothesis Testing method; Assuming minimum acceptable kappa 0.6 and Expected kappa 0.85, Significance level 0.05, and Power 90%, including the Expected dropout rate of 10% in the study, 117 patients were included in the study. Demographic findings, personal history, laboratory tests, PAP values of the patients calculated by the emergency physicians and cardiologists were recorded.

Results: The study included 117 patients who attended the emergency department with shortness of breath or chest pain complaints. While 72.6% of them are female, 27.4% are male patients. The age of the patients included in the study was a minimum of 33 and a maximum of 80. Their mean age and deviation were 59.6±10.6. According to the criteria for PAP measurement ≤20 and >20, a significant and almost perfect agreement was found between the measurements of the cardiologist and the emergency physicians (Cohen's Kappa Coefficient 0.86; <0.0001).
Conclusion: We found near-perfect agreement between cardiologists and emergency room physicians trained in focused cardiac ultrasound (FOCUS) in detecting normal or increased PAP.