Chen et al: Accuracy, precision, and interobserver and intraobserver agreements related to pressure-measurement devices
Veterinary Surgery 4, 2024

🔍 Key Findings

  • WMg (water manometer with gauge) was the most accurate and precise pressure measurement device.
  • APT (arterial pressure transducer) was less accurate than WMg but still precise; it differed significantly from the gold standard (WMr).
  • CCT (Compass CT) was the least accurate and precise and differed significantly from the set pressure.
  • Mean differences from set pressure were smallest for WMg (−0.020 cm H2O), moderate for APT (−0.390 cm H2O), and largest for CCT (−1.267 cm H2O).
  • All devices showed excellent interobserver (ICC = 1.000) and intraobserver agreement (ICC range 0.985–0.998).
  • Even though the CCT performed least well, all devices had mean errors ≤1.3 cm H2O, indicating potential clinical utility.
  • WMg or WMr should be preferred in surgical settings due to superior accuracy and precision.
  • Measurement precision is more critical than accuracy during PSS surgery, as a 1 mm Hg (~1.3 cm H2O) increase in portal pressure raises odds of poor outcomes by 9%.

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Chen et al: Accuracy, precision, and interobserver and intraobserver agreements related to pressure-measurement devices
Veterinary Surgery 4, 2024

🔍 Key Findings

  • WMg (water manometer with gauge) was the most accurate and precise pressure measurement device.
  • APT (arterial pressure transducer) was less accurate than WMg but still precise; it differed significantly from the gold standard (WMr).
  • CCT (Compass CT) was the least accurate and precise and differed significantly from the set pressure.
  • Mean differences from set pressure were smallest for WMg (−0.020 cm H2O), moderate for APT (−0.390 cm H2O), and largest for CCT (−1.267 cm H2O).
  • All devices showed excellent interobserver (ICC = 1.000) and intraobserver agreement (ICC range 0.985–0.998).
  • Even though the CCT performed least well, all devices had mean errors ≤1.3 cm H2O, indicating potential clinical utility.
  • WMg or WMr should be preferred in surgical settings due to superior accuracy and precision.
  • Measurement precision is more critical than accuracy during PSS surgery, as a 1 mm Hg (~1.3 cm H2O) increase in portal pressure raises odds of poor outcomes by 9%.

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Multiple Choice Questions on this study

In Chen 2024 et al., on pressure-measurement tools, which device demonstrated the highest accuracy and precision?

A. Compass CT (CCT)
B. Arterial pressure transducer (APT)
C. Water manometer with ruler (WMr)
D. Water manometer with gauge (WMg)
E. Hand-held sphygmomanometer

Answer: Water manometer with gauge (WMg)

Explanation: WMg was the only device not significantly different from the gold standard and had the smallest mean error (−0.020 cm H2O).
In Chen 2024 et al., on pressure-measurement tools, what was the largest mean error observed among the tested devices?

A. −0.020 cm H2O
B. −0.390 cm H2O
C. −1.267 cm H2O
D. 1.5 cm H2O
E. −2.5 cm H2O

Answer: −1.267 cm H2O

Explanation: The Compass CT showed the greatest deviation from set pressure, with a mean difference of −1.267 cm H2O.
In Chen 2024 et al., on pressure-measurement tools, which statement about observer agreement across the tested pressure devices is true?

A. Observer agreement was poor for CCT
B. APT had the highest observer variability
C. All devices showed excellent interobserver and intraobserver agreement
D. Only WMg showed high intraobserver reliability
E. CCT required extensive calibration to match APT

Answer: All devices showed excellent interobserver and intraobserver agreement

Explanation: ICC values ranged from 0.985–1.000 for all devices across users.
In Chen 2024 et al., on pressure-measurement tools, why is high precision potentially more critical than accuracy when monitoring portal pressures during PSS ligation?

A. Precision enables reuse of devices
B. Precise devices are less costly
C. Precision reduces intraoperative time
D. Precision allows reliable comparison of pre- and post-ligation values
E. Accuracy cannot be measured intraoperatively

Answer: Precision allows reliable comparison of pre- and post-ligation values

Explanation: Consistent readings help guide decisions about safe occlusion levels despite small bias.
In Chen 2024 et al., on pressure-measurement tools, how much does the risk of poor outcome increase per 1 mm Hg rise in portal pressure during complete PSS occlusion?

A. 5%
B. 7%
C. 9%
D. 12%
E. 15%

Answer: 9%

Explanation: A 1 mm Hg rise increases odds of failure by 9%, highlighting the need for precise monitoring.

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