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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Standardization of fetal ultrasound biometry measurements: Improving the quality and consistency of measurements
Ultrasound in Obstetrics and Gynecology, Volume 38, No. 6, Year 2011
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Description
Objective To assess whether a standardization exercise prior to commencing a fetal growth study involving multiple sonographers can reduce interobserver variation. Methods In preparation for an international study assessing fetal growth, nine experienced sonographers from eight countries participated in a standardization exercise consisting of theoretical and practical sessions. Each performed a set of seven standard fetal measurements on pregnant volunteers at 20-37 weeks' gestation, and these were repeated by the lead sonographer; all measurements were taken in a blinded fashion. After this the sonographers had hands-on practice and feedback sessions on other volunteers. This process was repeated three times. Measurement differences between sonographers and the lead sonographer, expressed as a gestational-age-specific Z-score, between the first and third scans were compared using the Wilcoxon signed ranks test, and variance was assessed using Pitman's test. Interobserver agreement was also assessed using the intraclass correlation coefficient (ICC), and all images were scored for quality in a blinded fashion. Results At baseline the level of agreement and image scoring were high. A significant reduction in the differences between sonographers and the lead sonographer were seen for fetal biometry overall (head circumference, abdominal circumference and femur length) between the first and third scans (median Z-scores, 0.46 and 0.24; P = 0.005), and a reduction in the variance was also observed (P < 0.001). The ICCs for measurement pairs for every fetal measurement showed a clear trend of increasing ICC (better agreement) with consecutive training scan sessions, although no improvement in image scores was seen. Conclusion Even for experienced sonographers, a standardization exercise before starting a study of fetal biometry can improve consistency of measurements. This could be of relevance for studies assessing fetal growth in multicenter sites. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors & Co-Authors
Sarris, Ippokratis
United Kingdom, Oxford
Green Templeton College
United Kingdom, Oxford
University of Oxford Medical Sciences Division
Ioannou, Christos
United Kingdom, Oxford
Green Templeton College
United Kingdom, Oxford
University of Oxford Medical Sciences Division
Dighe, Manjiri Kiran
United States, Seattle
Uw Medical Center – Montlake
Mitidieri, A.
Brazil, Pelotas
Universidade Federal de Pelotas
Oberto, Manuela
Italy, Turin
Università Degli Studi Di Torino
Qingqing, W.
China, Beijing
Beijing Obstertrics and Gynecology Hospital, Capital Medical University
Shah, Janki
Kenya, Nairobi
Aga Khan University Hospital, Nairobi
Sohoni, S.
Unknown Affiliation
Al Zidjali, W.
Unknown Affiliation
Hoch, L.
United Kingdom, Oxford
Green Templeton College
United Kingdom, Oxford
University of Oxford Medical Sciences Division
Altman, Douglas G.
United Kingdom, Oxford
University of Oxford Medical Sciences Division
Papageorghiou, Aris T.
United Kingdom, Oxford
Green Templeton College
United Kingdom, Oxford
University of Oxford Medical Sciences Division
Statistics
Citations: 81
Authors: 12
Affiliations: 7
Identifiers
Doi:
10.1002/uog.8997
ISSN:
09607692
e-ISSN:
14690705