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Operator experience impact on the evaluation of still images of a first trimester cardiac assessment protocol
- Source :
- The Journal of Maternal-Fetal & Neonatal Medicine. 35:1957-1961
- Publication Year :
- 2020
- Publisher :
- Informa UK Limited, 2020.
-
Abstract
- Objective: Congenital heart disease (CHD) is the most common birth defect and represents the leading cause for mortality and morbidity in infants and young adults. Early fetal echocardiography is usually considered a highly specialized scan. The goal of this study is to evaluate the impact of operator's experience in assessing still images of the 4-chamber view and 3-vessels view and to evaluate the feasibility and the performance of a first trimester screening protocol for CHD.Methods: An online questionnaire consisting of still images of the 4-camber view and 3-vessel view from 50 normal and abnormal cases was reviewed by an expert group made of seven obstetricians specialized in fetal medicine and a nonexpert group made of 13 obstetricians that are certified in ultrasound. After individually visualizing each image set made of the 4-chamber view and 3-vessel view, they had to conclude if the case was normal or abnormal and what images were abnormal.Results: A total of 50 image sets of both normal and abnormal fetal hearts were examined by the 20 reviewers, resulting in 1000 evaluations. The expert group achieved a detection rate of 97.1% with a false positive rate of 5.7%. The nonexpert group achieved also a good detection rate of 91.3% but with a much higher false positive rate of 33.9%. The most frequently missed CHD involved the great arteries and had a normal 4-chamber view. In the majority of false positive cases the 3-vessel view was incorrectly interpreted as abnormal.Conclusions: A screening protocol for CHD, based on the 4-chamber view and 3-vessel view alone can offer a good detection rate for CHD with a small false positive rate, but only if it is implemented by highly specialized sonographers.
- Subjects :
- Heart Defects, Congenital
Pediatrics
medicine.medical_specialty
Heart disease
030204 cardiovascular system & hematology
Ultrasonography, Prenatal
Young Adult
03 medical and health sciences
Fetal Heart
0302 clinical medicine
Pregnancy
medicine
Humans
Prospective Studies
Young adult
Set (psychology)
Protocol (science)
030219 obstetrics & reproductive medicine
medicine.diagnostic_test
business.industry
Obstetrics and Gynecology
medicine.disease
Pregnancy Trimester, First
First trimester
Great arteries
Pediatrics, Perinatology and Child Health
Female
False positive rate
business
Fetal echocardiography
Subjects
Details
- ISSN :
- 14764954 and 14767058
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- The Journal of Maternal-Fetal & Neonatal Medicine
- Accession number :
- edsair.doi.dedup.....d0097a465f2c4262cabddec48b53d8ed