I don't think you understand this matter.
You are fond of citing the consensus document.
Go and read it. As David (who is an author on it) has categorically told you, it clearly states that VGE grades are correlated to risk of DCS.
Simon M
Ah yes,,, cherry pick a specific condition.....
See ...
RECOMMENDATION 11
Bubble grade data are most appropriately analyzed nonparametrically.
Attempts to linearize bubble data should be
employed cautiously. Consideration should also be given to
ensure that studies are powered appropriately.
Fair interpretation
Interpretation of bubble data should be appropriately
constrained, for a number of reasons:
• bubbles do not equal DCS;
• the intravascular focus of current technology provides
an incomplete picture of conditions in the body;
• the standard techniques of aural Doppler and twodimensional
cardiac imaging do not allow bubble sizing;
• Doppler technology captures only a limited threedimensional
space and two-dimensional images only a
slice of the three-dimension eld.
Most measures are made intermittently, capturing a small
percentage of total time.
While recognition of limitations is the responsibility
of authors, peer reviewers should critically evaluate
manuscripts for shortcomings.