RESUMO
AIMS: To assess the feasibility of conducting a large-scale quality-control exercise on the echocardiographic grading of mitral regurgitation (MR). METHODS AND RESULTS: One hundred and fifty-two practising cardiologist and sonographer echocardiographers attended a dedicated session within a national meeting and were asked to review echocardiographic images of five case studies and evaluate the severity of MR using a six-point scale. The group's overall evaluation was analysed together with the variation in grading of severity. The proportion of gradings of MR more than one grade either side of the mode was <10% in all but one case, and <10% were inaccurately evaluated as inside categories of severe when the modal grading was outside and vice versa. However in a case where a single grading difference had important clinical implications, substantial variability was seen. CONCLUSIONS: Conducting a large-scale quality-control exercise in the assessment of mitral regurgitation is feasible. Overall results suggesting reasonable consistency in reporting may hide substantial clinically relevant variability. It is essential that increasing importance is attached to the development, conduct, and analysis of quality control within echocardiography if it is to maintain and extend its role as a key investigation for patients with heart disease.