European Journal of Vascular & Endovascular Surgery
Re. ‘Doppler Ultrasound Examination of Multiple Sclerosis Patients and Control Participants: Inter-observer Agreement and Association with Disease’ https://www.facebook.com/photo.php?fbid=554128491322555&set=a.116899871712088.18007.100001762281491&type=1&theater


Foto's van Alessandro Rasman
European Journal of Vascular & Endovascular Surgery
Re. ‘Doppler Ultrasound Examination of Multiple Sclerosis Patients and Control Participants: Inter-observer Agreement and Association with Disease’
E. Menegatti, S. Gianesini
published online 07 October 2013
PDF: https://docs.google.com/file/d/0B_Ed_wxZvab3NllGc21XME41cGM/edit?usp=sharing

We read the article of Laukontaus et al. with great interest.
This study, once again, confirms the poor inter-observer agreement between ultrasound-skilled operators but without specific training for CCSVI investigation. It has been demonstrated already that agreement significantly increases when the operators have attended specific training and complete their own learning curve. However, a good agreement has been reported limitedly to criterion 3 (CSA <0.3 cm2), finding it positive in 45% of the control participants, in 65% of multiple sclerosis (MS) patients with early
diagnosis (p < .09), and in 70% of MS patients with late diagnosis (p <.022). These data confirm significant differences between MS patients and healthy control participants.

Furthermore, the authors did not investigate the 3b and 2 criteria, recommended in the Consensus approved by seven Vascular International Scientific Societies. To the contrary, the authors followed the ESNCH protocol, always negative when applied for CCSVI, and refused to apply a protocol specifically designed to improve reproducibility and comparison
among studies. — met Shirley Renshaw en 15 anderen.