Ultrasound
EPIQ CVx

Designed for cardiologists.
Built for better care.
Evaluating the technical features and user experience of Philips EPIQ CVx

2Ultrasound | EPIQ CVx

Background

MethodPhilips has introduced a dedicatedcardiology ultrasound system: the Philips
EPIQ CVx. The new system delivers thelatest technology advancements andinsights gained from both imaging
cardiologists and sonographers.
The EPIQ CVx is designed around theneeds of both diagnostic andinterventional cardiologists working in
adult and pediatric medicine.

The study was performed by Use-Lab
with the assistance of Philips employees
at the 2017 EACVI EuroEcho-Imaging
Congress held in Lisbon, Portugal.
In total, 42 experienced echo
cardiographers, specializing in diagnostic
and/or interven-tional cardiology,
were surveyed. Each participant received
a live demonstration of the iE33 and the
EPIQ CVx. Subsequently, they were asked
to indicate the extent to which theyagreed with a number of pre-formulated
statements (‘claims’) comparing theperformance, usability and workflow
of the two systems.

To evaluate the functionality, performanceand usability of its latest development,
Philips engaged an independent usability
engineering consultancy and interface
design expert, Use-Lab GmbH from
Steinfurt, Germany. Use-Lab was tasked
with conducting a study to compare
the new EPIQ CVx to the Philips iE33
ultrasound system.

Results
The participants overwhelmingly felt, basedon their average 18.5 years of experience,that the performance and usability of thePhilips EPIQ CVx exceeded that of thePhilips iE33 system. The individual claims
are outlined on pages 8 and 9.

Overview
The EPIQ CVx is a dedicated cardiac ultrasound systemthat offers a wide range of 2D and 3D transthoracic andtransesophageal echo imaging. It delivers exceptional image
quality and significant advances seeking to address the strains
on today’s overburdened staff and healthcare systems.
To assess acceptance of the new EPIQ CVx cardiac ultrasoundsystem, Philips enlisted the support of Use-Lab, from Steinfurt,
Germany, an independent usability engineering consultancy
and interface design agency. The evaluation, designed by
Use-Lab, aimed to validate customer perception of the new
EPIQ CVx relative to the well established Philips iE33.
This was done utilizing a claims-based investigation protocol.

The specific areas evaluated were:• Ease of operation and workflow• Improved image quality: sharper and clearer image• Improved diagnostic confidence• Increased lab throughput• Simplification and efficiency of interventional procedures
The new EPIQ CVx includes all the features of the iE33 plus
additional unique developments designed to meet the needsof today’s diagnostic and interventional cardiologists.
The innovations presented to the study participants included:• Configurable touchscreen user interface• Dynamic HeartModel A.I. cardiac quantification• PureWave pediatric S9-2 transducer• Live 3D photorealistic rendering• MultiVue MPR alignment• AutoSTRAIN as a tested feature
Please refer to page 10 and 11 for feature descriptions.

EPIQ CVx | Ultrasound3

Study methodology
1. Process and procedure
The validation study was designed to gather subjective input
on a number of pre-defined claims relating to individual
product features of the EPIQ CVx as well as to the system in
its entirety. The study was jointly conducted by Use-Lab
and Philips. Use-Lab was responsible for data capture,
analysis and reporting while Philips recruited and scheduled
respondents and introduced them to the EPIQ CVx system.
Philips and Use-Lab compiled a list of 33 statements (‘claims’)
pertaining to the functionality, performance, and usabilityof EPIQ CVx. Questions were derived from these claims andpresented in two questionnaires as statements or questions.
Respondents were asked to indicate the extent to which theyagreed with each statement using the five-point Likert scale– ranging from “I agree” to “I disagree”, and sometimes,
depending on the wording of the claim – ‘very easy’ to‘very difficult’.
In December 2017 at the EACVI EuroEcho-Imaging Congressin Lisbon, 42 current Philips iE33 users from 17 countries
participated in the evaluation sessions.
Before the demonstrations and questioning began, respondents
were welcomed and given a short overview of the procedure.
They were then asked to complete consent and confidentiality
paperwork and provide details of their clinical background.
Based on the information they gave, and whether their interests
lay mainly in diagnostic or interventional cardiology (or both),they were asked to complete the first of two questionnaires.
The first questionnaire (tailored to the relevant professional
profile) addressed general thoughts on working with ultrasound,including the iE33; and was filled out by imaging clinicians
prior to seeing the EPIQ CVx. After completing this questionnaire,participants were given a brief refresher demonstration on
the iE33 system with the aim of re‑familiarizing them withkey functions.

Subsequently, respondents were taken to another room
containing the EPIQ CVx system. Here, a Philips trainer
explained the system’s features and demonstrated themon the system. Study participants were invited to try out
the touchscreen themselves, by moving the virtual lightsource and 3D image of a photorealistic 3D rendering.
After the EPIQ CVx demonstration, participants were asked
to complete a second questionnaire and rate their agreementwith the defined claims using the aforementioned scale.
If the respondent indicated they managed pediatric patients,
they received an additional questionnaire pertaining to theuse of ultrasound in pediatric cardiology.
A pre-defined, standardized script for both the iE33 refresher
and the EPIQ CVx demonstration ensured a consistentbaseline for all respondents, helping to maintain the reliabilityof the data. Throughout all live demonstrations and while
participants filled out the questionnaires, Use-Lab teammembers oversaw the process and presentations to ensure
consistency of message across all sessions as well as answer
participants' queries and concerns.
2. Profile of respondents
All activities related to screening and recruiting respondents
and scheduling sessions were performed by Philips.
Philips recruited from its network of current ultrasound clientsand at its official booth in the EuroEcho exhibition hall.
Everyone who took part was an experienced ultrasound user.
Various subgroups were defined ahead of the study in orderto tailor the sessions to the respondents’ clinical interests.
Participating clinicians were categorized as primarily diagnostic,
primarily interventional, or both diagnostic and interventional.
Furthermore, they were asked to indicate whether they also
treated pediatric patients.

The overall profile of the participants – Respondent characteristics
Category

Characteristics

NumberSex

FemaleMale

17
25

Years of experience

Median / range

18.5 years / 7 - 48 years

Type of facility(multiple responses possible)

Type of facility / number of
respondents

University
PublicPrivateCountries represented
Specialty(multiple responses possible)

4

Ultrasound | EPIQ CVx

29
17
10

17
Primary focus / number of
respondents

Adult D&I
Adult diagnostic
Pediatric – D&I
Sonographer

30
3
8
2

Additionally see pediatric patients

5

EPIQ CVx | Ultrasound5

Example of how a claim was formed
Claim 12 is evaluated based on two statements. 37 of 38 respondents agreed to the first statement; 37 of 38 agreed to thesecond statement. However, a total of 36 of 38 agreed to both statements, because two different respondents did not agreewith statements 1 and 2. This leads to an overall agreement of 94% (36 of 38 respondents).

Question / statement

Total
responses

1

2

3

4

5

Statement
agreement (4&5)

n%

n%

n%

n%

n%

n

%

I believe good alignment isessential to measuring valves
for correct device sizing.

38

00%

00%

12%

37%

3489%

37

97%

I believe the EPIQ MultiVue– live 3D cropping and MPRalignment tool could improvealignment accuracy for sizing
the relevant device for theprocedure.

38

00%

00%

12%

1128%

2668%

37

97%

Overall

38

36

94%

Data analysis
Use-Lab collected respondent data and responses ina confidential manner; responses were not linked toa respondent’s name. During and following completionof the questionnaire, there was no verbal discussion withthe respondent regarding the questionnaire or the responses.
Use-Lab handled all finalized questionnaires and data, which
was not shared with Philips until the final data was provided.
Post data collection, all gathered information was thenanalyzed. Due to the nature of the method used during thisinvestigation, descriptive statistics were used to analyze thedata. These data analyses provided a basis for a judgment
about whether certain claims can be supported.
Many claims are supported by more than one question.
To determine the percentage agreement with these claims,
the percentage of respondents who agreed with every
supporting question was calculated.

6

Ultrasound | EPIQ CVx

Key findings and highlights
Diagnostic confidence

Usability and workflow• 78% of clinicians1 who saw the new EPIQ CVx perceived it asable to drive improved diagnostic confidence due to improved
image quality, anatomical intelligence (Dynamic HeartModelA.I.
– Innovations to HeartModel A.I.) and advanced visualization
tools (e.g., TrueVue and the OLED monitor).

• 92% of clinicians2 who saw EPIQ CVx believed it would beeasy to operate.

• 90% of clinicians1 who saw the new EPIQ CVx felt the new
TrueVue 3D photorealistic rendering improved viewing of
anatomical structures thus increasing clinical confidence.
• 89% of clinicians3 who saw the new EPIQ CVx perceived
it as able to drive improved confidence during procedure
guidance due to improved image quality, advanced
workflow (MultiVue – Live 3D cropping and MPR alignmenttool), and advanced visualization tools (e.g., TrueVue andthe OLED monitor).
1
2
3
4

Based on responses from 41 respondents
Based on responses from 42 respondents
Based on responses from 38 respondents
Based on responses from 31 respondents• 90% of clinicians2 think with the use of touchscreen,it’s easy to move/rotate photorealistic TrueVue renderingand positioning light source.
• 85% of clinicians1 who saw EPIQ CVx thought thecustomization of the user interface would improve theiron-cart scanning workflow.
• 100% of clinicians4 who saw the new EPIQ CVx believe
the EPIQ CVx's AutoStrain software is easier to use than
the iE33's strain package.
• 75% of clinicians1 who saw the new EPIQ CVx felt the
EPIQ CVx monitor provided an enhanced user experience.
• 86% of clinicians3 who saw the new EPIQ CVx thought that 7
the new cardiac user interface would help make ultrasoundguided procedures more streamlined.

EPIQ CVx | Ultrasound7

Overall claims

EPIQ CVx diagnostic feature claims

ResultResult92% of clinicians1 who saw EPIQ CVx believed it would
be easy to operate.

TrueVuebased on responses from 42 respondents

90% of clinicians1 think with the use of touch screen
it’s easy to move/rotate photorealistic TrueVue
rendering and positioning light source.

1

95% of clinicians1 who saw the new EPIQ CVx believed
it offered improved image quality: sharper and clearer
images.
1

based on responses from 42 respondents

78% of clinicians1 who saw the new EPIQ CVx perceived
it as able to drive improved diagnostic confidence due
to improved image quality, anatomical intelligence*,
and advanced visualization tools*** Dynamic HeartModel A.I. – Innovations to HeartModel A.I.
**e.g., TrueVue and the OLED monitor.
1
based on responses from 41 respondents

1

90% of clinicians1 who saw the new EPIQ CVx felt the
new TrueVue 3D photorealistic rendering improved
viewing of anatomical structures thus increasing clinicalconfidence.
1

85% of clinicians1 who saw EPIQ CVx thought thecustomization of the UI would improve their on-cart
scanning workflow.
based on responses from 41 respondents

OLED
75% of clinicians1 who saw the new EPIQ CVx felt
the EPIQ CVx monitor provided an enhanced user
experience.

Result
The new pediatric PureWave transducer is designed toallow for scanning across a wider body habitus. 84%
of clinicians1 who see pediatric patients and saw
the new EPIQ CVx, believe that this can lead to lessswitching of transducers during an exam resulting infaster scans.
1

based on responses from 42 respondents

User interface (UI)1

EPIQ CVx diagnostic pediatricfeature claims

based on responses from 42 respondents

based on responses from 13 respondents

92% of clinicians who work with pediatric patients andsaw the new EPIQ CVx thought the coronary submodeon EPIQ CVx would enable them to evaluate coronary
arteries and flow more quickly and more easily.

1based on responses from 41 respondents

Dynamic HeartModel A.I.
97% of clinicians1 who saw the new EPIQ CVx believed
quicker left-heart quantification would result inincreased lab throughput.
1

based on responses from 41 respondents

1

1

based on responses from 13 respondents

92% of clinicians1 who see pediatric patients and saw
the new EPIQ CVx thought they would be able todetect disease states such as Kawasakis, anomalous
coronaries or coronary artery fistulas better withEPIQ CVx's coronary submode than with their current
systems.
1

based on responses from 13 respondents

92% of clinicians1 who see pediatric patients and saw
the new EPIQ CVx thought the new PureWave S9-2transducer would allow for superior imaging for 2D
mode.
1

based on responses from 13 respondents

Coronary modes
92% of clinicians1 who work with pediatric patients andsaw the new EPIQ CVx thought the coronary submodeon EPIQ CVx would enable them to evaluate coronary
arteries and flow more quickly and more easily.
1based on responses from 13 respondents

TOMTEC AutoSTRAIN
100% of clinicians1 who saw the new EPIQ CVx believe
the EPIQ CVx's AutoSTRAIN software is easier to use
than the iE33's strain package.
1

based on responses from 31 respondents

100% of clinicians1 who saw the new EPIQ CVx believe
the EPIQ CVx's AutoSTRAIN software is easier to use
than the iE33's strain package.
1

based on responses from 31 respondents

96% of clinicians1 who saw the new EPIQ CVx believe
EPIQ CVx's AutoSTRAIN software is faster than theiE33's strain package.
1

based on responses from 31 respondents

96% of clinicians1 who saw the new EPIQ CVx believe
EPIQ CVx's AutoSTRAIN software is easier to use andfaster than the iE33's strain package.
1

8

Ultrasound | EPIQ CVx

based on responses from 31 respondents

EPIQ CVx interventional feature claims
ResultResult83% of clinicians1 who saw the new EPIQ CVx believedthat EPIQ CVx would help to reduce the time needed
for ultrasound guidance during Cardioband (Edwards)
and tricuspid valve procedures.

71% of clinicians1 who saw the new EPIQ CVx believedthat the new photorealistic TrueVue rendering can help
to facilitate communication between the interventional
cardiologist and the echocardiologist during complex
ultrasound guided procedures.

1

based on responses from 30 respondents

1

80% of clinicians who saw the new EPIQ CVx thoughtthat using EPIQ CVx in combination with the newLive 3D TEE would help to increase the efficiency ofultrasound guided procedures. Where efficiency means
quicker ultrasound guidance during procedures.

based on responses from 38 respondents

1

1

based on responses from 30 respondents

94% of clinicians who saw the new EPIQ CVx thoughtthat it would permit them to guide innovative
procedures.
1

1

based on responses from 38 respondents

89% of clinicians1 who saw the new EPIQ CVx perceived
it as able to drive improved confidence during
procedure guidance due to improved image quality,
advanced workflow*, and advanced visualization
tools*** X's MultiVue – Live 3D cropping and MPR alignment tool**e.g., TrueVue and the OLED monitor.
1
based on responses from 38 respondents

MultiVue
100% of clinicians1 who saw the new EPIQ CVx believedthat using the EPIQ CVx MultiVue alignment tool would
simplify echo guidance for complex procedures.
1

84% of clinicians1 who saw the new EPIQ CVx thought
having the capability to move the light source insidephotorealistic TrueVue rendering would make Live
3D images easier to understand during complex
procedures.
1

based on responses from 38 respondents

User interface (UI)
85% of clinicians1 who saw EPIQ CVx thought thecustomization of the UI would improve their on-cart
scanning workflow.
1

based on responses from 41 respondents

86% of clinicians1 who saw the new EPIQ CVx thoughtthat the new cardiac user interface would help makeultrasound guided procedures more streamlined.
1

based on responses from 38 respondents

OLED
75% of clinicians1 who saw the new EPIQ CVx felt the
EPIQ CVx monitor provided an enhanced user
experience.
1

based on responses from 41 respondents

based on responses from 38 respondents

84% of clinicians1 who saw the new EPIQ CVx believedthat the EPIQ MultiVue alignment tool would be easy
to use.
1based on responses from 38 respondents

94% of clinicians1 who saw the new EPIQ CVx thought
the EPIQ MultiVue alignment tool could help to reduce
the risk of choosing an incorrectly sized device during
interventional procedures.
1

based on responses from 38 respondents

TrueVue
90% of clinicians1 think with the use of touch screen it’seasy to move/rotate photorealistic TrueVue renderingand positioning light source.
1

based on responses from 42 respondents

90% of clinicians1 who saw the new EPIQ CVx felt the
new TrueVue 3D photorealistic rendering improved
viewing of anatomical structures thus increasing
clinical confidence.
1

based on responses from 42 respondents

EPIQ CVx | Ultrasound9

Selected features

TrueVue – photorealistic rendering
For improved visualization of cardiac anatomy intransesophageal and transthoracic echo, Philips cardiology
TrueVue, with its virtual light source makes it simpler tovisualize the location of defects and comprehend depth within
the structures. In interventional cardiology, TrueVue helps
clinicians visualize the location of catheters and devices
by providing images with improved tissue detail and depth
perception. Since it offers a viewing context for the echo
images, caregivers in the interventional suite can rely on
support when communicating complicated echo images
and enhance their procedural confidence.

MultiVue – live MPR alignment
During an interventional procedure, MultiVue on the Philips
EPIQ CVx provides one-click alignment of the Live 3D
volume and the MPR views as well as a way to crop thevolume if required. This helps interventional cardiologists
provide the right image at the right moment, or to makefaster 3D measurements, for example for device sizing during
mitral valve repair. It also provides a home position in live
scanning to ensure that the clinician returns to the sameorientation when back in Live 3D.

Dynamic HeartModel A.I.
cardiac quantification
Philips Dynamic HeartModel A.I. is a 3D tool which provides
robust, reproducible ejection fraction (EF) in seconds aspart of a routine workflow. Dynamic HeartModel A.I. shows
moving contours of the left ventricle (LV) and left atrium (LA)volumes. It also highlights newly automated measurements,
including LV Mass and indices. Dynamic HeartModel A.I.
now allows multi-beat analysis enabling quantificationof patients who may be in arrhythmias.

AutoSTRAIN
AutoSTRAIN is the first TOMTEC application being integrated
on EPIQ CVx. It’s uniquely powered by advanced automation
technologies: Automatic View Recognition which
automatically recognizes and labels which view is the apical
4 chamber, 2 chamber and 3 chamber view and AutomaticContour Placement which automatically detects and places
the left ventricle border. It delivers a one-button-push,robust and reproducible global longitudinal strain (GLS)
measurement for everyday clinical use

Coronary sub-mode
The one-button coronary sub-mode, now on many
cardiology transducers, helps clinicians who see pediatricpatients detect disease states such as Kawasakis,
anomalous coronaries and coronary artery fistulas.

S9-2 PureWave transducer
The next-generation pediatric 2D TTE PureWave S9-2transducer allows you to visualize extraordinary levels ofdetail and contrast resolution with exceptional penetration
at higher frequencies through ultra-wide bandwidth andnext-generation single-crystal technologies that reinforces
exceptional tissue information at greater depths with lessnoise. The S9-2 transducer comes with a one-button coronary
sub-mode designed for easier and faster evaluation of thecoronary artery.

10

Ultrasound | EPIQ CVx

OLED monitor
The 22-inch, 2nd generation OLED monitor on thePhilips EPIQ CVx gives you an image 38% larger
than traditional ultrasound images with no loss ofresolution. As well as a 180° viewing angle, it alsodelivers a greater dynamic range, and a wider colour
range over its predecessor. This enhances your viewof side-by-side, colour compare, and all images.

User interface
The Philips EPIQ CVx has a user-configurable layoutof the controls on the touch screen, allowing clinicians
to position their most-used functions where they wantthem. The system has a tablet-like interface, which
supports pinching, zooming and rotating even of 3D
datasets. The new cardiac user interface is designed
to dramatically decrease reach.

Conclusions
The Use-Lab analysis of the participant’s responses to the new Philips EPIQ CVx
showed a generally high level of agreement for the claims evaluation.
Respondents predominantly experienced and expressed favorable impressionsof the Philips EPIQ CVx cardiac ultrasound system, both as a whole and withregards to the individual features. This impression is reflected in the high overalllevels of agreement with the claims.

EPIQ CVx | Ultrasound11© 2018 Koninklijke Philips N.V. All rights reserved.
www.philips.com

4522 991 37811 * OCT 2018