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  • A novel algorithm for classification of interatrial communications within the oval fossa in the newborn: Results from the Copenhagen Baby Heart Study

  • Sofie Dannesbo, Elisabeth Blixenkrone-Moeller, Christian A. Pihl, Anne-Sophie Sillesen, Ruth O. Voegg, Agnes S. Davidsen, Louise E. Lind, Dorthe L. Jeppesen, Charlotte Kruse, Betina Noerager, James K. Dodd, Finn S. Jorgensen, Anna A. Raja, Steven D. Colan, Luc Mertens, Vibeke E. Hjortdal, Niels Vejlstrup, Robert H. Anderson, Henning Bundgaard, Kasper Iversen
  • Journal:
    Cardiology in the Young / Volume 33 / Issue 10 / October 2023
    Published online by Cambridge University Press:
    21 November 2022, pp. 1942-1949
    • Article
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  • Background:

    An interatrial communication is present in most neonates. The majority are considered the “normal” patency of the oval foramen, while a minority are abnormal atrial septal defects. Differentiation between the two with transthoracic echocardiography may be challenging, and no generally accepted method of classification is presently available. We aimed to develop and determine the reliability of a new classification of interatrial communications in newborns.

    Methods and Results:

    An algorithm was developed based on echocardiographic criteria from 495 newborns (median age 11[8;13] days, 51.5% females). The algorithm defines three main categories: patency of the oval foramen, atrial septal defect, and no interatrial communication as well as several subtypes. We found an interatrial communication in 414 (83.6%) newborns. Of these, 386 (93.2%) were categorised as patency of the oval foramen and 28 (6.8%) as atrial septal defects.

    Echocardiograms from another 50 newborns (median age 11[8;13] days, 36.0% female), reviewed by eight experts in paediatric echocardiography, were used to assess the inter- and intraobserver variation of classification of interatrial communications into patency of the oval foramen and atrial septal defect, with and without the use of the algorithm. Review with the algorithm gave a substantial interobserver agreement (kappa = 0.66), and an almost perfect intraobserver agreement (kappa = 0.82). Without the use of the algorithm, the interobserver agreement between experienced paediatric cardiologists was low (kappa = 0.20).

    Conclusion:

    A new algorithm for echocardiographic classification of interatrial communications in newborns produced almost perfect intraobserver and substantial interobserver agreement. The algorithm may prove useful in both research and clinical practice.

The Cambridge Handbook of Applied Perception Research
  • Edited by Robert R. Hoffman, Peter A. Hancock, Mark W. Scerbo, Raja Parasuraman, James L. Szalma
  • Published online:
    05 July 2015
    Print publication:
    26 January 2015
  • The Cambridge Handbook of Applied Perception Research covers core areas of research in perception with an emphasis on its application to real-world environments. Topics include multisensory processing of information, time perception, sustained attention, and signal detection, as well as pedagogical issues surrounding the training of applied perception researchers. In addition to familiar topics, such as perceptual learning, the Handbook focuses on emerging areas of importance, such as human-robot coordination, haptic interfaces, and issues facing societies in the twenty-first century (such as terrorism and threat detection, medical errors, and the broader implications of automation). Organized into sections representing major areas of theoretical and practical importance for the application of perception psychology to human performance and the design and operation of human-technology interdependence, it also addresses the challenges to basic research, including the problem of quantifying information, defining cognitive resources, and theoretical advances in the nature of attention and perceptual processes.

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