Computerised Interpretation of Fetal Heart Rate During Labour (INFANT): A Randomised Controlled Trial

Abstract

Link to publication on Research at Birmingham portal General rightsUnless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law.• Users may freely distribute the URL that is used to identify this publication.• Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research.• User may use extracts from the document in line with the concept of 'fair dealing' under the Copyright, Designs and Patents Act 1988 (?) • Users may not further distribute the material nor use it for the purposes of commercial gain.Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document.When citing, please reference the published version. Take down policyWhile the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.

The Use of Artificial Intelligence in Automation in the Fields of Gynaecology and Obstetrics – an Assessment of the State of Play

“…A heated debate, illustrative of the occasional difficulties encountered in employing automated techniques in clinical prac-tice, is under-way regarding the potential benefits of computerassisted assessment of peripartal foetal heart rate (electronic foetal heart rate monitoring), which, due to the clear interobserver variability and subjectivity in assessing CTG abnormalities, could, at least theoretically, benefit from objective automated analysis. Prospective randomised data from the INFANT study group did not demonstrate any advantage over conventional visual assessment by medical staff present during delivery, neither in neonatal short-term outcomes nor in outcomes at two years [87]. The question of how far methodological weaknesses in the design of the study contributed to these non-significant differences between the study arms (Hawthorne effect) remains open [88,89], especially since other computer-based approaches delivered clearly promising data [90].…”

Prelabor and intrapartum Doppler ultrasound to predict fetal compromise

“…Although a low fetal CPR 82,[85][86][87]89,90 or low prelabor maternal levels of placental growth factor 115 are risk factors for intrapartum fetal compromise, both seem to be insufficiently robust to be used as a reliable screening test. Furthermore, neither computerized analysis of fetal heart rate patterns 116 or fetal ECG 117 have been shown to improve important clinical outcomes.…”

Évaluation des solutions fondées sur l’apprentissage machine en santé

“…La vérification du rendement par des études sur la validation interne et clinique ne répond pas à une question fondamentale : l'intégration des solutions fondées sur l'apprentissage machine à la médecine clinique comportetelle des avantages pour les patients 26 3,27 . On trouve un ERC à double insu sur un algo rithme visant à détecter les complications neurologiques aiguës et un essai comparant l'effet de l'interprétation automatique des cardiotocographies à celle des soins traditionnels sur les issues cliniques chez les mères et les nourrissons 28,29 . La rareté des ERC en apprentissage machine peut s'expliquer par le besoin de grands de patients ou de longues durées de suivi pour montrer l'efficacité, les coûts et les problèmes relevant de la fidélité de l'intervention ou de la contamination entre les groupes lorsque les essais sont menés dans le même établissement.…”