Beat and view aggregation rules for tricuspid regurgitant jet dimensions: simulation code and results

Abstract

Code, configurations, seeds, results and figures for a Monte Carlo simulation study of composite multi-beat, multi-view transoesophageal echocardiographic measurement rules for tricuspid regurgitant jet dimensions (beat averaging, percentage beat-consistency windows, largest view mean, millimetre cross-view triggers) and of how reference standards built from them change the apparent performance of artificial intelligence models. The study is methodological and used no patient data; results are conditional on the generative model. Protocol stages: the planned analyses of an initial protocol (results/2026-09-18_full, with the second level of long-axis underestimation of a first amendment), post hoc exploratory sensitivity analyses (results/2026-09-18_sens), a second amendment (results/2026-09-18_amend2, secondary) and a third amendment of post hoc sensitivity analyses (results/2026-10-05_osrev). The study was not registered and is not pre-specified as a whole; see README.md. Includes the parameter table, lab notebook, automated tests with a full test log, and second implementations used for software verification. Licences: code under the MIT licence; results, figures and documentation under Creative Commons Attribution 4.0 International (CC BY 4.0); see LICENSE and LICENSE-DATA. Funding: Disruptive Technologies Innovation Fund (DTIF), Enterprise Ireland, grant DT20240543A.