Nuchal Translucency Quality Review (NTQR) program: first one and half million results. (February 2015)

• Record Type: Journal Article
• Authors: Cuckle, H.; Platt, L. D.; Thornburg, L. L.; Bromley, B.; Fuchs, K.; Abuhamad, A.; Benacerraf, B.; Copel, J. A.; Depp, R.; D'Alton, M.; Goldberg, J.; O'Keeffe, D.; Spitz, J.; Toland, G.; Wapner, R.; for the Nuchal Translucency Quality Review Program of the Perinatal Quality Foundation
• Is Part Of: Ultrasound in obstetrics & gynecology. Volume 45:Number 2(2015:Feb.)
• Page Start: 199
• Page End: 204
• Publication Date: 2015-02
• Subjects: Ultrasonics in obstetrics -- Periodicals; Generative organs, Female -- Diseases -- Diagnosis -- Periodicals; Diagnosis, Ultrasonic -- Periodicals; Genital Diseases, Female -- ultrasonography -- Periodicals; Ultrasonography, Prenatal -- Periodicals; 618.047543
• DOI: 10.1002/uog.13390
• Languages: English
• ISSNs: 0960-7692

Abstract

<abstract abstract-type="main" id="uog13390-abs-0001"> <title>ABSTRACT</title> <sec id="uog13390-sec-0001" sec-type="section"> <title>Objective</title> <p id="uog13390-para-0001">To evaluate the performance of first‐trimester nuchal translucency (NT) measurement by providers (physician‐sonologists and sonographers) within the Nuchal Translucency Quality Review (NTQR) program.</p> </sec> <sec id="uog13390-sec-0002" sec-type="section"> <title>Methods</title> <p id="uog13390-para-0002">After training and credentialing providers, the NTQR monitored performance of NT measurement by the extent to which an individual's median multiple of the normal median (MoM) for crown–rump length (CRL) was within the range 0.9–1.1 MoM of a published normal median curve. The SD of log<sub>10</sub> MoM and regression slope of NT on CRL were also evaluated. We report the distribution between providers of these performance indicators and evaluate potential sources of variation.</p> </sec> <sec id="uog13390-sec-0003" sec-type="section"> <title>Results</title> <p id="uog13390-para-0003">Among the first 1.5 million scans in the NTQR program, performed between 2005 and 2011, there were 1 485 944 with CRL in the range 41–84 mm, from 4710 providers at 2150 ultrasound units. Among the 3463 providers with at least 30 scans in total, the median of the providers' median NT‐MoMs was 0.913. Only 1901 (55%) had a median NT‐MoM within the expected range; there were 89 above 1.1 MoM, 1046 at 0.8–0.9 MoM, 344 at 0.7–0.8 MoM and 83 below 0.7 MoM. There was a small increase in the median NT‐MoM according to providers' length of time in the NTQR program and number of scans entered annually. On average, physician‐sonologists had a higher median NT‐MoM than did sonographers, as did those already credentialed before joining the program. The median provider SD was 0.093 and the median slope was 13.5%. SD correlated negatively with the median NT‐MoM (<italic>r</italic> = −0.34) and positively with the slope (<italic>r</italic> = 0.22).</p> </sec> <sec id="uog13390-sec-0004" sec-type="section"> <title>Conclusion</title> <p id="uog13390-para-0004">Even with extensive training, credentialing and monitoring, there remains considerable variability between NT providers. There was a general tendency towards under‐measurement of NT compared with expected values, although more experienced providers had performance closer to that expected. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.</p> </sec> </abstract>