ArticleDiagnostics (Basel, Switzerland)2019
Value and Diagnostic Efficacy of Fetal Morphology Assessment Using Ultrasound in A Poor-Resource Setting.
Article in Diagnostics (Basel, Switzerland), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- What do radiologists look for? Advances and limitations of perceptual learning in radiologic search.Journal of vision · 2020Review
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4 authors at 2 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundUltrasound is operator-dependent, and its value and efficacy in fetal morphology assessment in a low-resource setting is poorly understood. We assessed the value and efficacy of fetal morphology ultrasound assessment in a Nigerian setting. MATERIALS AND
methodsWe surveyed fetal morphology ultrasound performed across five facilities and followed-up each fetus to ascertain the outcome. Fetuses were surveyed in the second trimester (18th-22nd weeks) using the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) guideline. Clinical and surgical reports were used as references to assess the diagnostic efficacy of ultrasound in livebirths, and autopsy reports to confirm anomalies in terminated pregnancies, spontaneous abortions, intrauterine fetal deaths, and still births. We calculated sensitivity, specificity, positive and negative predictive values, Area under the curve (AUC), Youden index, likelihood ratios, and post-test probabilities.
resultsIn total, 6520 fetuses of women aged 15-46 years (mean = 31.7 years) were surveyed. The overall sensitivity, specificity, and AUC were 77.1 (95% CI: 68-84.6), 99.5 (95% CI: 99.3-99.7), and 88.3 (95% CI: 83.7-92.2), respectively. Other performance metrics were: positive predictive value, 72.4 (95% CI: 64.7-79.0), negative predictive value, 99.6 (95% CI: 99.5-99.7), and Youden index (77.1%). Abnormality prevalence was 1.67% (95% CI: 1.37-2.01), and the positive and negative likelihood ratios were 254 (95% CI: 107.7-221.4) and 0.23 (95% CI: 0.16-0.33), respectively. The post-test probability for positive test was 72% (95% CI: 65-79).
conclusionFetal morphology assessment is valuable in a poor economics setting, however, the variation in the diagnostic efficacy across facilities and the limitations associated with the detection of circulatory system anomalies need to be addressed.
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