not accept a diagnosis of CHF based upon ejection fraction alone. Thus, it is important for both clinical and research purposes to estimate the agreement between quantitative measurements and the cardiologists' qualitative interpretation reported on echo METHODS: All patients at a university-affiliated VAMC who had an echo between 12/96 and 12/99 were identified by electronic medical records (N = 5,505). One record per patient was identified and for each echo, we abstracted both quantitative (fractional shortening and fractional area change) and qualitative (cardiologists' interpretation) data. We excluded reports with missing quantitative (N = 912) or qualitative (N = 85) data. Abnormal numeric data was defined as fractional shortening less than 0. 1 8 or fractional area change less than 0.35. Abnormal textual report was defined as left ventricular systolic dysfunction or generalized wall motion abnormality. We then calculated agreement from a 2Â2 table. RESULTS: Of 4,508 patients with echos in our study, 1237 had an abnormal echo by quantitative and/or qualitative data (Table) . Of these 1237 patients, an abnormality was identified by both strategies in only 548 (44%) of patients. Discrepancies rates between qualitative and quantitative reports were similar. The cardiologists' interpretation of the echo was normal when the numeric data were abnormal 41% (386/937) and the cardiologist's interpretation was abnormal with normal numeric data 35% (303/851).