• Rohit Kumar, Tajamul Hussain Shah, Vijay Hadda, Pawan Tiwari, Saurabh Mittal, Karan Madan, Maroof Ahmad Khan, and Anant Mohan.
• Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
• World J Crit Care Med. 2019 Nov 19; 8 (7): 127-134.

BackgroundData regarding the agreement among multiple operators for measurement of quadriceps muscle thickness by bedside ultrasonography (USG) are sparse.AimTo statistically assess the agreement among 5 operators for measurement of quadriceps muscle thickness on bedside USG.MethodsThis was a cross-sectional observational study. The 5 operators of varied experience (comprised of 1 critical care consultant, 2 fellows, and 2 nurses) independently measured quadriceps muscle thickness in triplicate for 45 critically ill patients each, using USG. Intra- and interrater agreement rates among the 5 operators were assessed using intraclass correlation coefficient (ICC) and expressed with 95% confidence interval (CI).ResultsThe 5 operators produced a total of 135 readings and 675 observations for ICC calculations to determine the intraoperator and interoperator variations respectively. For intraoperator agreement, the overall ICC (95%CI) was 0.998 (0.997, 0.999) for operator 1, 0.998 (0.997, 0.999) for operator 2, 0.997 (0.995, 0.999) for operator 3, 0.999 (0.998, 0.999) for operator 4, and 0.998 (0.997, 0.999) for operator 5. For interoperator agreement, the overall ICC (95%CI) was 0.977 (0.965, 0.986; P < 0.001) for reading 1, 0.974 (0.960, 0.984; P < 0.001) for reading 2, and 0.975 (0.961, 0.985; P < 0.001) for reading 3.ConclusionUSG measurement of quadriceps muscle thickness was not dependent on clinical experience, supporting training for nurses in it.©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

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