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Variability of automated carotid intima-media thickness measurements by novice operators

Nichols, S.; Milner, M.; Meijer, R.; Carroll, S.; Ingle, L.


S. Nichols

M. Milner

R. Meijer


Carotid intima-media thickness (C-IMT) measurements provide a non-invasive assessment of sub-clinical atherosclerosis. The aim of the study was to assess the inter- and intra-observer variability of automated C-IMT measurements undertaken by two novice operators using the Panasonic CardioHealth Station. Participants were free from cardio-metabolic disease and each underwent serial bilateral C-IMT ultrasound measurements. Immediate inter operator measurement variability was calculated by comparing initial measurements taken by two operators. Immediate retest variability was calculated from two consecutive measurements and longer-term variability was assessed by conducting a further scan one week later. 50 apparently healthy participants (n=20 females), aged 26.2 ± 5.0 years were recruited. Operator 1 recorded a median (inter-quartile range) right and left-sided C-IMT of 0.471mm (0.072mm) and 0.462mm (0.047mm). Female’s right and left C-IMT was 0.442mm (0.049mm) and 0.451mm (0.063mm) respectively. The limits of agreement (LoA) for immediate inter-operator variability were -0.063 to 0.056mm (mean bias -0.003mm). Operator 1’s immediate retest intra-operator LoA were -0.057 to 0.046mm (mean bias was -0.005mm). One week LoA were -0.057 to 0.050mm (mean bias -0.003mm).Operator 2 recorded median right and left sided C-IMT of 0.467mm (0.089mm) and 0.458mm (0.046mm) for males respectively whilst female measurements were 0.441mm (0.052mm) and 0.444mm (0.054mm) respectively. Operator 2’s intra-operator immediate retest LoA were -0.056 to 0.056 (mean bias


Nichols, S., Milner, M., Meijer, R., Carroll, S., & Ingle, L. (2016). Variability of automated carotid intima-media thickness measurements by novice operators. Clinical physiology and functional imaging, 36(1), 25-32.

Journal Article Type Article
Acceptance Date Aug 15, 2014
Online Publication Date Sep 12, 2014
Publication Date 2016-01
Deposit Date May 13, 2015
Publicly Available Date May 13, 2015
Journal Clinical physiology and functional imaging
Print ISSN 1475-0961
Electronic ISSN 1475-097X
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 36
Issue 1
Pages 25-32
Keywords Reliability, Reproducibility, C-IMT, Ultrasound
Public URL
Publisher URL
Additional Information Author's accepted manuscript of article published in : Clinical physiology and functional imaging, 2014 at