TY - JOUR
T1 - Image-scoring system for umbilical and uterine artery pulsed-wave Doppler ultrasound measurement
AU - Molloholli, M.
AU - Napolitano, R.
AU - Ohuma, E. O.
AU - Ash, S.
AU - Wanyonyi, S. Z.
AU - Cavallaro, A.
AU - Giudicepietro, A.
AU - Barros, F.
AU - Carvalho, M.
AU - Norris, S.
AU - Min, A. M.
AU - Zainab, G.
AU - Papageorghiou, A. T.
N1 - Funding Information:
We thank the pregnant women who participated in this study and to the sonographers involved in submitting images for evaluation. This study is part of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) Project, which is supported by a grant from The Bill & Melinda Gates Foundation to the University of Oxford, for which we are grateful. A.T.P. is supported by the Oxford Partnership Comprehensive Biomedical Research Centre with funding from the Department of Health NIHR Biomedical Research Centre’s funding scheme.
Publisher Copyright:
Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Objectives: To develop an objective image-scoring system for pulsed-wave Doppler measurement of maternal uterine and fetal umbilical arteries, and evaluate how this compares with subjective assessment. Methods: As an extension to the INTERGROWTH-21 st Project, we developed a scoring system based on six predefined criteria for uterine and umbilical artery pulsed-wave Doppler measurements. Objective evaluation using the scoring system was compared with subjective assessment which consisted of classifying an image as simply acceptable or unacceptable. Based on sample size estimation, a total of 120 umbilical and uterine artery Doppler images were selected randomly from the INTERGROWTH-21 st image database. Two independent reviewers evaluated all images in a blinded fashion, both subjectively and using the six-point scoring system. Percentage agreement and kappa statistic were compared between the two methods. Results: The overall agreement between reviewers was higher for objective assessment using the scoring system (agreement, 85%; adjusted kappa, 0.70) than for subjective assessment (agreement, 70%; adjusted kappa, 0.47). For the six components of the scoring system, the level of agreement (adjusted kappa) was 0.97 for anatomical site, 0.88 for sweep speed, 0.77 for magnification, 0.68 for velocity scale, 0.68 for image clarity and 0.65 for angle of insonation. Conclusion: In quality assessment of umbilical and uterine artery pulsed-wave Doppler measurements, our proposed objective six-point image-scoring system is associated with greater reproducibility than is subjective assessment. We recommend this as the preferred method for quality control, auditing and teaching.
AB - Objectives: To develop an objective image-scoring system for pulsed-wave Doppler measurement of maternal uterine and fetal umbilical arteries, and evaluate how this compares with subjective assessment. Methods: As an extension to the INTERGROWTH-21 st Project, we developed a scoring system based on six predefined criteria for uterine and umbilical artery pulsed-wave Doppler measurements. Objective evaluation using the scoring system was compared with subjective assessment which consisted of classifying an image as simply acceptable or unacceptable. Based on sample size estimation, a total of 120 umbilical and uterine artery Doppler images were selected randomly from the INTERGROWTH-21 st image database. Two independent reviewers evaluated all images in a blinded fashion, both subjectively and using the six-point scoring system. Percentage agreement and kappa statistic were compared between the two methods. Results: The overall agreement between reviewers was higher for objective assessment using the scoring system (agreement, 85%; adjusted kappa, 0.70) than for subjective assessment (agreement, 70%; adjusted kappa, 0.47). For the six components of the scoring system, the level of agreement (adjusted kappa) was 0.97 for anatomical site, 0.88 for sweep speed, 0.77 for magnification, 0.68 for velocity scale, 0.68 for image clarity and 0.65 for angle of insonation. Conclusion: In quality assessment of umbilical and uterine artery pulsed-wave Doppler measurements, our proposed objective six-point image-scoring system is associated with greater reproducibility than is subjective assessment. We recommend this as the preferred method for quality control, auditing and teaching.
KW - growth restriction
KW - image scoring
KW - quality control
KW - reproducibility
KW - umbilical artery Doppler
KW - uterine artery Doppler
UR - http://www.scopus.com/inward/record.url?scp=85061105576&partnerID=8YFLogxK
U2 - 10.1002/uog.19101
DO - 10.1002/uog.19101
M3 - Article
C2 - 29808615
AN - SCOPUS:85061105576
SN - 0960-7692
VL - 53
SP - 251
EP - 255
JO - Ultrasound in Obstetrics and Gynecology
JF - Ultrasound in Obstetrics and Gynecology
IS - 2
ER -