Quality management of nuchal translucency ultrasound measurement in Australia

Abstract

Teleconference tutorials are a convenient, accessible and effective way to obtain immediate and sustained improvement in operator performance.

United States' experience in nuchal translucency measurement: variation according to provider characteristics in over five million ultrasound examinations

“…Our prior data were limited in terms of our ability to review provider characteristics, but the current, larger dataset shows that those providers with longer duration within the NTQR program, those with a higher annual volume of scans, and those with more NT-credentialed providers at their practice site had greater accuracy of measurement (higher NT median MoM) and greater consistency of measurement (lower SD of log 10 NT MoM). This is similar to findings of other studies, in which providers with low annual scan volumes and less experienced providers were more likely to be assigned remediation or require additional monitoring 19,25 . However, other studies have not shown a clear relationship of individual providers' consistency of measurement with their annual scan volume, finding an association only with operator experience 26,27 .…”

“…The NTQR data have been able to provide a robust, detailed NT referent curve for the majority of the USA population that underwent NT screening over the 15-year period from January 2005 to December 2019, and these data confirm that ongoing assessment of accuracy through a national registry and feedback program has resulted in significant improvement and consistency within this single measured analyte for first-trimester screening, with more than 85% of physicians and sonologists providing consistent measurements within appropriate ranges 9,11,19,24 . Our prior data were limited in terms of our ability to review provider characteristics, but the current, larger dataset shows that those providers with longer duration within the NTQR program, those with a higher annual volume of scans, and those with more NT-credentialed providers at their practice site had greater accuracy of measurement (higher NT median MoM) and greater consistency of measurement (lower SD of log 10 NT MoM).…”

“…The data were submitted electronically by the laboratories, reducing the likelihood of provider error or incomplete reporting, and assuring that these data represent the vast majority of NT ultrasound examinations performed in the USA during this period. The NTQR database now represents one of the largest available referent curves for NT measurement, which should be used as a population standard to establish measurement norms 10,11,14,[18][19][20] .…”

Sonologist's characteristics related to a higher quality in fetal nuchal translucency measured in primary antenatal care centers

“…Nisbet et al proposed 1‐hour teleconference tutorials led by senior sonographers as a method to improve NT measurement quality. Improvement in NT measurement was seen after one audit cycle and was maintained over subsequent years, but they did not find statistically differences with the cohort group . In addition, sonologists with significant deviations could require retraining and exhaustive ultrasound supervision by expert sonologists .…”

“…Improvement in NT measurement was seen after one audit cycle and was maintained over subsequent years, but they did not find statistically differences with the cohort group. 27 In addition, sonologists with significant deviations could require retraining and exhaustive ultrasound supervision by expert sonologists. 8,26 This approach could be useful to reduce deviation and improve quality.…”