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Am J Obstet Gynecol. 2010 Nov;203(5):451.e1-7. doi: 10.1016/j.ajog.2010.05.037. Epub 2010 Jul 15.

Comparison of 5 experts and computer analysis in rule-based fetal heart rate interpretation.

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  • 1Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California-San Francisco, San Francisco, CA, USA.

Abstract

OBJECTIVE:

The purpose of this study was to measure agreement among 5 expert clinicians and a computerized method with the use of a strict fetal heart rate classification method.

STUDY DESIGN:

Five providers independently scored 769 8-minute segments from the last 3 hours of 30 tracings with the use of a 5-tier color-coded framework that contains pattern descriptions and proposals for management. Computer analysis was performed with PeriCALM Patterns (PeriGen, Princeton, NJ) to detect and classify patterns.

RESULTS:

The clinicians agreed exactly with the majority opinion in 57% (95% confidence interval [CI], 49-64%) of the segments and were within 1 color code in 89% (95% CI, 81-96%). The average proportion of agreement was 0.83 (95% CI, 0.73-0.94). Weighted Kappa scores averaged 0.58 (range, 0.48-0.68). The computer-based results were not statistically different: 0.87 and 0.52, respectively.

CONCLUSION:

These 5 clinicians achieved moderate-to-substantial levels of agreement overall using a strictly defined method to classify fetal heart rate tracings. The result of the computerized method was similar to the conclusions of these clinicians.

PMID:
20633869
DOI:
10.1016/j.ajog.2010.05.037
[PubMed - indexed for MEDLINE]
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