Quality control of ultrasonography markers for Down’s syndrome screening: a retrospective study by the laboratory
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Blanca Badal
,
Antonieta Ballesteros
Abstract
Objectives
Quality control of ultrasonography markers is necessary to ensure greater efficacy of prenatal aneuploidy screening. The aim of this study was to assess the quality of the crown-rump length (CRL) and nuchal translucence (NT) measurement accuracy by the laboratory according to quality indicators.
Methods
Retrospective observational study on 4,908 single-foetus pregnant women who underwent prenatal aneuploidy screening in the first trimester of pregnancy. Euploid foetuses with CRL between 45 and 84 mm were included, while those with NT≥3.5 mm were excluded. CRL measurement was considered to be accurate if the median multiples of the median (MoM) for pregnancy-associated plasma protein A (PAPP-A) was between 0.90 and 1.10. Fifteen sonographers participated in the study, six of whom comprised the control group. Systematic error for a sonographer was considered when CRL measurement was greater than ±2 mm with respect to the control group. Quality for NT was assured by means of the WHIRI method and each sonographer cumulative sum control chart (CUSUM).
Results
For CRL accuracy, five sonographers underestimated the measurements, while another four overestimated them, with no statistical differences. For smaller sized foetuses, all sonographers met the established specifications. Regarding NT control, three sonographers did not meet the quality criteria for the median MoM. All sonographers met the specifications for the logarithmic standard deviation of the NT MoM levels. Thirteen sonographers met the CUSUM specifications.
Conclusions
Evaluation of a quality control of ultrasonography parameters by laboratory professionals is necessary to avoid under- or overestimation tendencies for CRL and NT measurements. CUSUM is a useful tool for the immediate correction of errors in NT measurements.
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Research ethics: The local Institutional Review Board deemed the study exempt from review.
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Research funding: None declared.
References
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© 2021 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
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- Review
- Systematic review and meta-analysis of observational studies evaluating glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCHL1) as blood biomarkers of mild acute traumatic brain injury (mTBI) or sport-related concussion (SRC) in adult subjects
- Opinion Papers
- From stable teamwork to dynamic teaming in the ambulatory care diagnostic process
- Bringing team science to the ambulatory diagnostic process: how do patients and clinicians develop shared mental models?
- Vitamin D assay and supplementation: still debatable issues
- Original Articles
- Developing a framework for understanding diagnostic reconciliation based on evidence review, stakeholder engagement, and practice evaluation
- Validity and reliability of Brier scoring for assessment of probabilistic diagnostic reasoning
- Impact of disclosing a working diagnosis during simulated patient handoff presentation in the emergency department: correctness matters
- Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned
- Time pressure in diagnosing written clinical cases: an experimental study on time constraints and perceived time pressure
- A decision support system to increase the compliance of diagnostic imaging examinations with imaging guidelines: focused on cerebrovascular diseases
- Bridging the divide: addressing discrepancies between clinical guidelines, policy guidelines, and biomarker utilization
- Unnecessary repetitions of C-reactive protein and leukocyte count at the emergency department observation unit contribute to higher hospital admission rates
- Quality control of ultrasonography markers for Down’s syndrome screening: a retrospective study by the laboratory
- Short Communications
- Unclassified green dots on nucleated red blood cells (nRBC) plot in DxH900 from a patient with hyperviscosity syndrome
- Bayesian intelligence for medical diagnosis: a pilot study on patient disposition for emergency medicine chest pain
- Case Report – Lessons in Clinical Reasoning
- A delayed diagnosis of hyperthyroidism in a patient with persistent vomiting in the presence of Chiari type 1 malformation
- Letters to the Editor
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- Barriers to diagnostic error reduction in Japan
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- Reviewer Acknowledgment
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