Abstract 16238: Inter-Tester Reproducibility of Fetal Doppler Indices of Cardiac Function
Introduction: Doppler echocardiography is emerging as a method to identify cardiovascular dysfunction in fetuses with suspected cardiac abnormalities and inform decisions for fetal or perinatal interventions. It is clinically important to understand the reproducibility of these measures, particularly between testers. While studies have reported intra- and inter-observer variability, little is known about inter-tester variability for these measures.
Hypothesis: We hypothesized that despite being a high volume fetal echocardiography laboratory, fetal Doppler measurements will demonstrate higher inter-tester variability compared with inter- and intra-observer variability of the same measurements.
Methods: Prospective study of uncomplicated, singleton pregnancies to evaluate various fetal Doppler measures of cardiovascular function. One sonographer obtained pre-defined Doppler variables and then a second sonographer obtained the same pre-defined variables 15 minutes after the first sonographer. Separate measurements were obtained by the two sonographers to evaluate intra- and inter-observer variability (on first acquisition) as well as inter-test variability (between both acquisitions).
Results: Twenty-nine fetuses between 17-36 weeks gestation were enrolled. A significant number of variables had excellent or good inter-tester intraclass correlation coefficient (ICC), comparable to the intra- and inter-observer ICC. However, a similar percent of variables had fair or poor inter-tester ICC which contrasted with excellent or good intra- and inter-observer ICC (Table 1).
Conclusions: In conclusion, within a laboratory highly experienced in Doppler fetal echocardiography, intra- and inter-observer reproducibility is good for most fetal Doppler parameters. However, inter-tester reproducibility is fair or poor for several Doppler variables, notably time-based variables (e.g. Tei index) and venous Doppler flow indices.
Author Disclosures: C.C. Allen: None. R. Keller: None. K.C. Barnard: None. Z. Gao: None. E.C. King: None. E.C. Michelfelder: None.
- © 2016 by American Heart Association, Inc.