Eintrag weiter verarbeiten
Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21
Gespeichert in:
| Zeitschriftentitel: | Ultrasound in Obstetrics & Gynecology |
|---|---|
| Personen und Körperschaften: | , , , , , |
| In: | Ultrasound in Obstetrics & Gynecology, 40, 2012, 2, S. 135-139 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Wiley
|
| Schlagwörter: |
| author_facet |
Kagan, K. O. Hoopmann, M. Baker, A. Huebner, M. Abele, H. Wright, D. Kagan, K. O. Hoopmann, M. Baker, A. Huebner, M. Abele, H. Wright, D. |
|---|---|
| author |
Kagan, K. O. Hoopmann, M. Baker, A. Huebner, M. Abele, H. Wright, D. |
| spellingShingle |
Kagan, K. O. Hoopmann, M. Baker, A. Huebner, M. Abele, H. Wright, D. Ultrasound in Obstetrics & Gynecology Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 Obstetrics and Gynecology Radiology, Nuclear Medicine and imaging Reproductive Medicine General Medicine Radiological and Ultrasound Technology |
| author_sort |
kagan, k. o. |
| spelling |
Kagan, K. O. Hoopmann, M. Baker, A. Huebner, M. Abele, H. Wright, D. 0960-7692 1469-0705 Wiley Obstetrics and Gynecology Radiology, Nuclear Medicine and imaging Reproductive Medicine General Medicine Radiological and Ultrasound Technology http://dx.doi.org/10.1002/uog.11095 <jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To assess the repeatability of crown–rump length (CRL) measurement and examine the effect of its over‐ and underestimation on first‐trimester combined screening.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Intra‐ and interoperator repeatability of CRL measurement at 11–13 weeks of gestation was assessed in 124 cases by two operators. Raw data were transformed into gestational age and intra‐ and interoperator repeatability was evaluated by within‐operator standard deviation (SD) and the SD of differences in measurements between both operators. Modeling techniques were used to assess the impact of CRL measurement error on general population screening and on the operator‐specific screening performance. The impact of errors in CRL measurement were investigated by simulating fetal nuchal translucency (NT) measurements and multiple of the median (MoM) values for pregnancy‐associated plasma protein A (PAPP‐A) and free β‐human chorionic gonadotropin (β‐hCG) for 500 000 euploid and 500 000 trisomy 21 pregnancies at 12 weeks and 9 weeks of gestation, and adding to or subtracting from each CRL value up to 10 mm and recalculating patient‐specific risks.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Within‐operator SD of the CRL measurement was 1.27 days of gestation. The SD of the differences in CRL measurement between operators was 1.37 days of gestation. Both intra‐ and interoperator 95% limits of agreement were around ± 5 mm. In general population‐based screening, a CRL measurement error SD of 5 mm accounts for an estimated 5% of the SD of log MoM PAPP‐A and less than 1% of the SD of log MoM free β‐hCG. Modeling the effect of removing this measurement error on overall screening performance showed a minimal impact. For a risk cut‐off of 1 in 100, the benefit in terms of overall screening performance would be an increase in detection rate of about 1% and a reduction in false‐positive rate of less than 0.1%. With regard to the operator‐specific screening performance, a consistent 5‐mm underestimation of CRL reduces the detection rate from 84% to 79% and the false‐positive rate from 2.4% to 1.2%. With a consistent 5‐mm overestimation the rates would be 88% and 5.6%, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The impact of the interoperator variability in CRL measurement on patient‐specific risk needs to be taken into account when interpreting first‐trimester screening results. A systematic under‐ or overestimation of CRL should be avoided. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</jats:p></jats:sec> Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 Ultrasound in Obstetrics & Gynecology |
| doi_str_mv |
10.1002/uog.11095 |
| facet_avail |
Online Free |
| finc_class_facet |
Medizin Technik Physik |
| format |
ElectronicArticle |
| fullrecord |
blob:ai-49-aHR0cDovL2R4LmRvaS5vcmcvMTAuMTAwMi91b2cuMTEwOTU |
| id |
ai-49-aHR0cDovL2R4LmRvaS5vcmcvMTAuMTAwMi91b2cuMTEwOTU |
| institution |
DE-Zwi2 DE-D161 DE-Gla1 DE-Zi4 DE-15 DE-Rs1 DE-Pl11 DE-105 DE-14 DE-Ch1 DE-L229 DE-D275 DE-Bn3 DE-Brt1 |
| imprint |
Wiley, 2012 |
| imprint_str_mv |
Wiley, 2012 |
| issn |
0960-7692 1469-0705 |
| issn_str_mv |
0960-7692 1469-0705 |
| language |
English |
| mega_collection |
Wiley (CrossRef) |
| match_str |
kagan2012impactofbiasincrownrumplengthmeasurementatfirsttrimesterscreeningfortrisomy21 |
| publishDateSort |
2012 |
| publisher |
Wiley |
| recordtype |
ai |
| record_format |
ai |
| series |
Ultrasound in Obstetrics & Gynecology |
| source_id |
49 |
| title |
Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_unstemmed |
Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_full |
Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_fullStr |
Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_full_unstemmed |
Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_short |
Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_sort |
impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| topic |
Obstetrics and Gynecology Radiology, Nuclear Medicine and imaging Reproductive Medicine General Medicine Radiological and Ultrasound Technology |
| url |
http://dx.doi.org/10.1002/uog.11095 |
| publishDate |
2012 |
| physical |
135-139 |
| description |
<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To assess the repeatability of crown–rump length (CRL) measurement and examine the effect of its over‐ and underestimation on first‐trimester combined screening.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Intra‐ and interoperator repeatability of CRL measurement at 11–13 weeks of gestation was assessed in 124 cases by two operators. Raw data were transformed into gestational age and intra‐ and interoperator repeatability was evaluated by within‐operator standard deviation (SD) and the SD of differences in measurements between both operators. Modeling techniques were used to assess the impact of CRL measurement error on general population screening and on the operator‐specific screening performance. The impact of errors in CRL measurement were investigated by simulating fetal nuchal translucency (NT) measurements and multiple of the median (MoM) values for pregnancy‐associated plasma protein A (PAPP‐A) and free β‐human chorionic gonadotropin (β‐hCG) for 500 000 euploid and 500 000 trisomy 21 pregnancies at 12 weeks and 9 weeks of gestation, and adding to or subtracting from each CRL value up to 10 mm and recalculating patient‐specific risks.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Within‐operator SD of the CRL measurement was 1.27 days of gestation. The SD of the differences in CRL measurement between operators was 1.37 days of gestation. Both intra‐ and interoperator 95% limits of agreement were around ± 5 mm. In general population‐based screening, a CRL measurement error SD of 5 mm accounts for an estimated 5% of the SD of log MoM PAPP‐A and less than 1% of the SD of log MoM free β‐hCG. Modeling the effect of removing this measurement error on overall screening performance showed a minimal impact. For a risk cut‐off of 1 in 100, the benefit in terms of overall screening performance would be an increase in detection rate of about 1% and a reduction in false‐positive rate of less than 0.1%. With regard to the operator‐specific screening performance, a consistent 5‐mm underestimation of CRL reduces the detection rate from 84% to 79% and the false‐positive rate from 2.4% to 1.2%. With a consistent 5‐mm overestimation the rates would be 88% and 5.6%, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The impact of the interoperator variability in CRL measurement on patient‐specific risk needs to be taken into account when interpreting first‐trimester screening results. A systematic under‐ or overestimation of CRL should be avoided. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</jats:p></jats:sec> |
| container_issue |
2 |
| container_start_page |
135 |
| container_title |
Ultrasound in Obstetrics & Gynecology |
| container_volume |
40 |
| format_de105 |
Article, E-Article |
| format_de14 |
Article, E-Article |
| format_de15 |
Article, E-Article |
| format_de520 |
Article, E-Article |
| format_de540 |
Article, E-Article |
| format_dech1 |
Article, E-Article |
| format_ded117 |
Article, E-Article |
| format_degla1 |
E-Article |
| format_del152 |
Buch |
| format_del189 |
Article, E-Article |
| format_dezi4 |
Article |
| format_dezwi2 |
Article, E-Article |
| format_finc |
Article, E-Article |
| format_nrw |
Article, E-Article |
| _version_ |
1792345355728191495 |
| geogr_code |
not assigned |
| last_indexed |
2024-03-01T17:22:09.176Z |
| geogr_code_person |
not assigned |
| openURL |
url_ver=Z39.88-2004&ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fvufind.svn.sourceforge.net%3Agenerator&rft.title=Impact+of+bias+in+crown%E2%80%93rump+length+measurement+at+first%E2%80%90trimester+screening+for+trisomy+21&rft.date=2012-08-01&genre=article&issn=1469-0705&volume=40&issue=2&spage=135&epage=139&pages=135-139&jtitle=Ultrasound+in+Obstetrics+%26+Gynecology&atitle=Impact+of+bias+in+crown%E2%80%93rump+length+measurement+at+first%E2%80%90trimester+screening+for+trisomy+21&aulast=Wright&aufirst=D.&rft_id=info%3Adoi%2F10.1002%2Fuog.11095&rft.language%5B0%5D=eng |
| SOLR | |
| _version_ | 1792345355728191495 |
| author | Kagan, K. O., Hoopmann, M., Baker, A., Huebner, M., Abele, H., Wright, D. |
| author_facet | Kagan, K. O., Hoopmann, M., Baker, A., Huebner, M., Abele, H., Wright, D., Kagan, K. O., Hoopmann, M., Baker, A., Huebner, M., Abele, H., Wright, D. |
| author_sort | kagan, k. o. |
| container_issue | 2 |
| container_start_page | 135 |
| container_title | Ultrasound in Obstetrics & Gynecology |
| container_volume | 40 |
| description | <jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To assess the repeatability of crown–rump length (CRL) measurement and examine the effect of its over‐ and underestimation on first‐trimester combined screening.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Intra‐ and interoperator repeatability of CRL measurement at 11–13 weeks of gestation was assessed in 124 cases by two operators. Raw data were transformed into gestational age and intra‐ and interoperator repeatability was evaluated by within‐operator standard deviation (SD) and the SD of differences in measurements between both operators. Modeling techniques were used to assess the impact of CRL measurement error on general population screening and on the operator‐specific screening performance. The impact of errors in CRL measurement were investigated by simulating fetal nuchal translucency (NT) measurements and multiple of the median (MoM) values for pregnancy‐associated plasma protein A (PAPP‐A) and free β‐human chorionic gonadotropin (β‐hCG) for 500 000 euploid and 500 000 trisomy 21 pregnancies at 12 weeks and 9 weeks of gestation, and adding to or subtracting from each CRL value up to 10 mm and recalculating patient‐specific risks.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Within‐operator SD of the CRL measurement was 1.27 days of gestation. The SD of the differences in CRL measurement between operators was 1.37 days of gestation. Both intra‐ and interoperator 95% limits of agreement were around ± 5 mm. In general population‐based screening, a CRL measurement error SD of 5 mm accounts for an estimated 5% of the SD of log MoM PAPP‐A and less than 1% of the SD of log MoM free β‐hCG. Modeling the effect of removing this measurement error on overall screening performance showed a minimal impact. For a risk cut‐off of 1 in 100, the benefit in terms of overall screening performance would be an increase in detection rate of about 1% and a reduction in false‐positive rate of less than 0.1%. With regard to the operator‐specific screening performance, a consistent 5‐mm underestimation of CRL reduces the detection rate from 84% to 79% and the false‐positive rate from 2.4% to 1.2%. With a consistent 5‐mm overestimation the rates would be 88% and 5.6%, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The impact of the interoperator variability in CRL measurement on patient‐specific risk needs to be taken into account when interpreting first‐trimester screening results. A systematic under‐ or overestimation of CRL should be avoided. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</jats:p></jats:sec> |
| doi_str_mv | 10.1002/uog.11095 |
| facet_avail | Online, Free |
| finc_class_facet | Medizin, Technik, Physik |
| format | ElectronicArticle |
| format_de105 | Article, E-Article |
| format_de14 | Article, E-Article |
| format_de15 | Article, E-Article |
| format_de520 | Article, E-Article |
| format_de540 | Article, E-Article |
| format_dech1 | Article, E-Article |
| format_ded117 | Article, E-Article |
| format_degla1 | E-Article |
| format_del152 | Buch |
| format_del189 | Article, E-Article |
| format_dezi4 | Article |
| format_dezwi2 | Article, E-Article |
| format_finc | Article, E-Article |
| format_nrw | Article, E-Article |
| geogr_code | not assigned |
| geogr_code_person | not assigned |
| id | ai-49-aHR0cDovL2R4LmRvaS5vcmcvMTAuMTAwMi91b2cuMTEwOTU |
| imprint | Wiley, 2012 |
| imprint_str_mv | Wiley, 2012 |
| institution | DE-Zwi2, DE-D161, DE-Gla1, DE-Zi4, DE-15, DE-Rs1, DE-Pl11, DE-105, DE-14, DE-Ch1, DE-L229, DE-D275, DE-Bn3, DE-Brt1 |
| issn | 0960-7692, 1469-0705 |
| issn_str_mv | 0960-7692, 1469-0705 |
| language | English |
| last_indexed | 2024-03-01T17:22:09.176Z |
| match_str | kagan2012impactofbiasincrownrumplengthmeasurementatfirsttrimesterscreeningfortrisomy21 |
| mega_collection | Wiley (CrossRef) |
| physical | 135-139 |
| publishDate | 2012 |
| publishDateSort | 2012 |
| publisher | Wiley |
| record_format | ai |
| recordtype | ai |
| series | Ultrasound in Obstetrics & Gynecology |
| source_id | 49 |
| spelling | Kagan, K. O. Hoopmann, M. Baker, A. Huebner, M. Abele, H. Wright, D. 0960-7692 1469-0705 Wiley Obstetrics and Gynecology Radiology, Nuclear Medicine and imaging Reproductive Medicine General Medicine Radiological and Ultrasound Technology http://dx.doi.org/10.1002/uog.11095 <jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To assess the repeatability of crown–rump length (CRL) measurement and examine the effect of its over‐ and underestimation on first‐trimester combined screening.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Intra‐ and interoperator repeatability of CRL measurement at 11–13 weeks of gestation was assessed in 124 cases by two operators. Raw data were transformed into gestational age and intra‐ and interoperator repeatability was evaluated by within‐operator standard deviation (SD) and the SD of differences in measurements between both operators. Modeling techniques were used to assess the impact of CRL measurement error on general population screening and on the operator‐specific screening performance. The impact of errors in CRL measurement were investigated by simulating fetal nuchal translucency (NT) measurements and multiple of the median (MoM) values for pregnancy‐associated plasma protein A (PAPP‐A) and free β‐human chorionic gonadotropin (β‐hCG) for 500 000 euploid and 500 000 trisomy 21 pregnancies at 12 weeks and 9 weeks of gestation, and adding to or subtracting from each CRL value up to 10 mm and recalculating patient‐specific risks.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Within‐operator SD of the CRL measurement was 1.27 days of gestation. The SD of the differences in CRL measurement between operators was 1.37 days of gestation. Both intra‐ and interoperator 95% limits of agreement were around ± 5 mm. In general population‐based screening, a CRL measurement error SD of 5 mm accounts for an estimated 5% of the SD of log MoM PAPP‐A and less than 1% of the SD of log MoM free β‐hCG. Modeling the effect of removing this measurement error on overall screening performance showed a minimal impact. For a risk cut‐off of 1 in 100, the benefit in terms of overall screening performance would be an increase in detection rate of about 1% and a reduction in false‐positive rate of less than 0.1%. With regard to the operator‐specific screening performance, a consistent 5‐mm underestimation of CRL reduces the detection rate from 84% to 79% and the false‐positive rate from 2.4% to 1.2%. With a consistent 5‐mm overestimation the rates would be 88% and 5.6%, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The impact of the interoperator variability in CRL measurement on patient‐specific risk needs to be taken into account when interpreting first‐trimester screening results. A systematic under‐ or overestimation of CRL should be avoided. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.</jats:p></jats:sec> Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 Ultrasound in Obstetrics & Gynecology |
| spellingShingle | Kagan, K. O., Hoopmann, M., Baker, A., Huebner, M., Abele, H., Wright, D., Ultrasound in Obstetrics & Gynecology, Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21, Obstetrics and Gynecology, Radiology, Nuclear Medicine and imaging, Reproductive Medicine, General Medicine, Radiological and Ultrasound Technology |
| title | Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_full | Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_fullStr | Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_full_unstemmed | Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_short | Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_sort | impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| title_unstemmed | Impact of bias in crown–rump length measurement at first‐trimester screening for trisomy 21 |
| topic | Obstetrics and Gynecology, Radiology, Nuclear Medicine and imaging, Reproductive Medicine, General Medicine, Radiological and Ultrasound Technology |
| url | http://dx.doi.org/10.1002/uog.11095 |