Feasibility and reproducibility of an image‐scoring method for quality control of fetal biometry in the second trimester

Salomon, L. J.; Bernard, J.-P.; Duyme, M.; Doris, Bass; Mas, N.; Ville, Y.

doi:10.1002/uog.2665

Cited by 118 publications

(120 citation statements)

References 16 publications

(20 reference statements)

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“…Many studies have attempted to quantify image quality 1 , 2 , 13 , 14 ; however this is the first to incorporate a training period to minimise error. The preliminary study provides the reviewer with clear expectations which standardises performance.…”

Section: Discussionmentioning

confidence: 99%

“…The sonographer's performance would reflect the quality of the scan. Due to the increase in malpractice lawsuits for undetected anomalies the ability to assess sonographer performance is crucial 2 . Performance may be assessed by reviewing image quality; however, the technical skills and protocols in performing this scan vary considerably between practitioners making evaluation difficult.…”

Section: Introductionmentioning

confidence: 99%

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The effect of preliminary training on quantitative evaluation of sonographer performance in the fetal morphology ultrasound examination

Lam

Samson

Magotti

et al. 2013

Australas J Ultrason Med

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Introduction: The aim of this study is to provide a quantitative scoring system to assess sonographer performance by reviewing images from the fetal morphology examination. Methods: Ten ultrasound images from patients at 18–22 weeks gestation were assessed and scored for quality according to predefined criteria. One hundred normal cases were randomly selected and 10 images from each case were analysed by four experienced reviewers. The preliminary training incorporated the first 25 cases and involved a training period for reviewers; the remaining 75 cases were allocated to post training. The scores acquired by each reviewer were statistically analysed using Pearson's and intra‐class correlations to determine the reproducibility of the results. Results: The preliminary training results were calculated separately and compared to the post training study. The preliminary intra‐class correlation coefficient was 0.12. In the post training study the intra‐class correlation coefficient was doubled at 0.24. The greatest correlation was observed between reviewers 1 and 4 with a coefficient of 0.71. Reviewers 3 and 4 demonstrated the lowest correlation coefficient of 0.30. Discussion: A significant increase in the intra‐class correlation coefficient indicated that training reviewers achieves more reproducible results. Suggested improvements to the study include recording fetal position, maternal BMI and assessing individual reviewer variability. An instruction manual defining each criterion might also yield better results. Conclusion: The quantitative method used in this study assessed ultrasound images by placing a numerical value on image quality. Analysis of the preliminary training period demonstrates improved reproducibility of the results. Further investigation into the criteria is necessary to refine the quantitative method.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of preliminary training on quantitative evaluation of sonographer performance in the fetal morphology ultrasound examination

Lam

Samson

Magotti

et al. 2013

Australas J Ultrason Med

View full text Add to dashboard Cite

show abstract

“…ces mesures pouvant être exprimée en multiple de la médiane --MoM --(le plus utilisé pour la nuque étant donné sa distribution non normale) ou les Z-scores (que nous avons utilisé) [11,13,19,20] ; • une approche qualitative dans laquelle les images sont jugées de manière subjective ou objective [6,13,14,17,18,21].…”

Section: Contrôle Qualité : Le Modèle De La Nuqueunclassified

Le contrôle de qualité en échographie prénatale : intérêt de la biométrie

Salomon

Bernard

Ville

2006

Gynécologie Obstétrique & Fertilité

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“…I would like to congratulate the authors of a recent paper in this journal on the feasibility of an image scoring method for quality control of fetal biometry in the second trimester 1 . They have made a valuable contribution to the literature in an area of work that is too often neglected, and have carefully addressed the areas of intra-and interobserver reproducibility.…”

mentioning

confidence: 99%

“…In this case cross-auditing and dual review where there are a significant number of cases of disagreement are helpful. Re: A new strategy for prenatal diagnosis of homozygous α 0 -thalassemia I read with interest the paper 'A new strategy for prenatal diagnosis of homozygous α 0 -thalassemia' by Leung et al 1 . The authors report their experience in non-invasive prenatal detection of Bart's disease at two hospitals in southern China.…”

mentioning

confidence: 99%

Re: Feasibility and reproducibility of an image‐scoring method for quality control of fetal biometry in the second trimester

Dudley

2006

Ultrasound in Obstet & Gyne

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CorrespondenceRe: Feasibility and reproducibility of an image-scoring method for quality control of fetal biometry in the second trimester I would like to congratulate the authors of a recent paper in this journal on the feasibility of an image scoring method for quality control of fetal biometry in the second trimester 1 . They have made a valuable contribution to the literature in an area of work that is too often neglected, and have carefully addressed the areas of intra-and interobserver reproducibility. I would also like to draw their attention to the earlier work of myself and my colleagues 2 , where we demonstrated the value of using such scoring as a feedback mechanism for training and coaching. We showed improvement in measurement quality over four cycles of audit, in both second and third trimesters, and demonstrated the value of the process in a wider trial in six centers 3 . We also found that comparing gestational ages from biparietal diameter and femoral length is a useful quantitative adjunct to image review.In our work we showed that ultrasound practitioners show improvement in two stages. Given feedback on quality criteria not met, they first demonstrate improved recognition of the relevant features. They then begin to further develop the technical skills required to meet the quality criteria. In order to measure baseline performance and demonstrate progress against these two distinct stages, it is important to record the practitioner's own assessment of image acceptability; in our studies we have asked them simply to record whether the image was acceptable or not (prospectively they make this assessment using the predefined quality criteria).Since this work was published we have carried out a larger scale study, as yet unpublished, including a large number of centers. In addition to head and abdomen measurements, we have reviewed femoral length and crown-rump-length images. We have also studied reviewer reproducibility; if a small number of reviewers discuss and agree the interpretation of quality criteria and review a number of images together, reproducibility is good, but cross-auditing, where each image is independently reviewed by two observers, is valuable. The approach is feasible on a large scale.I urge all centers undertaking fetal biometry to adopt these quality-control procedures and to ensure that they record the practitioner's own assessment to facilitate the two-stage improvement we have demonstrated. We have shown that the process is effective in generating improvements with a single experienced reviewer. However, where scan numbers are high, for example where the process is run on a multicenter basis, multiple reviewers will be required and both intra-and interobserver reproducibility become critical elements. In this case cross-auditing and dual review where there are a significant number of cases of disagreement are helpful. Feasibility and reproducibility of an image-scoring method for quality control of fetal biometry in the second trimester. N. Dudley

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Feasibility and reproducibility of an image‐scoring method for quality control of fetal biometry in the second trimester

Abstract: ObjectivesThe need for training programs and certification processes in fetal ultrasound has become obvious. The purpose of this study was to evaluate the feasibility of a score-based quality control system for fetal biometry in the second trimester. Methods

Cited by 118 publications

References 16 publications

The effect of preliminary training on quantitative evaluation of sonographer performance in the fetal morphology ultrasound examination

The effect of preliminary training on quantitative evaluation of sonographer performance in the fetal morphology ultrasound examination

Le contrôle de qualité en échographie prénatale : intérêt de la biométrie

Re: Feasibility and reproducibility of an image‐scoring method for quality control of fetal biometry in the second trimester

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