Abstract 14753: Impact of Automation on Time Burden of Echocardiographic LVEF Measurements: A Systematic Review and Meta-Analysis

Abstract

Introduction: Impact of time savings with the use of automated left ventricular volume measurements has not been systematically quantified. Hypothesis: Automated measurement of left ventricular volumes will lead to significant time savings. Methods: Electronic search of MEDLINE and EMBASE was performed. Inclusion criteria included 1) LVEF (either 2D or 3D) quantification using completely automated software, 2) comparator group of manual measurements and 3) stated mean and standard deviation of measurement time. Meta-analysis was performed with studies weighted by DerSimonian-Laird method and pooled using random-effects model. Results: 6 studies of automated 3D-LVEF measurement were identified with total of 697 pts. Time savings for 3D-LVEF automation was -371.0 seconds per study (95%CI -754.6 to +12.6 seconds, p = 0.058, Q (df=5) 2104.3, I2 99.9%), which was non-significant. HeartModel (Phillips) was used in 4 studies with 550 patients with non-significant time savings of -452.3 seconds (95%CI -1029.5 to +124.9 seconds, p=0.12, Q(df=3) 1954.1, I2 99.9%). 4D AutoLVQ (GE) was used in 1 study of 103 patients with significant time savings (142±30 sec vs. 226±114 sec, p<0.001). A single study of 44 pts used eSieLVA(Siemens) with significant time savings (37 ± 8 sec vs 371 ± 116 sec, p<0.001). For automated 2D-LVEF measurements, 6 studies were identified with total of 681 pts with total time savings with automation of -65.8 seconds, (95%CI -86.3 to -45.3 seconds, p < 0.001, Q(df=5) 86.1, I 2 98.7%). AutoEF (GE) was used in 3 studies with total of 230 pts with time-savings of -49.6 seconds (95%CI -59.6 to -39.7, p<0.0001, Q(df=2) 15.3, I2 88.2%). Auto EF (Siemens) was used in 2 studies, total 267 pts, with time savings of -75.2 seconds, (95%CI -118.3 to -32.1 sec, p=0.0006, Q(df=1) 24.7, I2 96.0%). A2DQ(Phillips) was used in 1 study of 184 pts (41 ± 5 sec vs. 98 ± 8 sec, p<0.001). Subgroup analysis did not reveal significant difference in time savings between 2D-LVEF software (p=0.26). Conclusions: Significant time savings were observed for automated 2D-LVEF measurements with nonsignificant trend for automated 3D-LVEF measurements. Adoption of automated LVEF measurements may contribute to improved echocardiography lab efficiency.