Construction of an Assessment Instrument for the Diagnostic Competence of Deep Vein Thrombosis Using Doppler Ultrasound

Abstract

Deep Vein Thrombosis (DVT) is one of the leading causes of cardiovascular death. Doppler ultrasound is the gold standard for diagnosis, but it has limitations due to its dependence on the skills of the imaging specialist. Radiologists in training need to develop cognitive, procedural, and attitudinal competencies. Therefore, it is imperative to have an instrument that objectively assesses the degree of diagnostic competence according to skill development. This descriptive, observational, longitudinal study focused on constructing an ad hoc rubric through a literature review. A pilot study was conducted to assess apparent validity, content validity, and interobserver agreement. A judging round was carried out for data analysis, and the modified Hernández-Nieto test was applied for quantitative content validation. Interobserver agreement was performed using Fleiss's kappa with the statistical program DATAtab. A rubric consisting of seven dimensions and four levels of execution was designed to evaluate the diagnostic competence of DVT by Doppler ultrasound. Appearance validation was performed using the Delphi method until the construct was unified. According to Hernández-Nieto, the content validity is excellent at 0.94, and the inter-observer agreement is good at 0. The evaluation instrument for diagnosing deep vein thrombosis using Doppler ultrasound is valid enough to be used with physicians in training. This allows for routine use in imaging education.