Interobserver variability in assessment of cranial ultrasound in very preterm infants

Hagmann, Cornelia; Halbherr, M; Koller, Brigitte; Wintermark, Pia; Huisman, Thierry A. G. M.; Bucher, Hans Ulrich

doi:10.1016/j.neurad.2010.12.008

Cited by 19 publications

(9 citation statements)

References 19 publications

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“…The overall κ values for the local and the central readers were moderate to good for severe injuries and poor to moderate for mild/moderate injuries. These findings are consistent with previously published interobserver cUS studies ( 23 , 24 , 25 ).…”

Section: Discussionsupporting

confidence: 93%

Brain injury in the international multicenter randomized SafeBoosC phase II feasibility trial: cranial ultrasound and magnetic resonance imaging assessments

et al. 2015

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Background:Abnormal cerebral perfusion during the first days of life in preterm infants is associated with higher grades of intraventricular hemorrhages and lower developmental score. In SafeBoosC II, we obtained a significant reduction of cerebral hypoxia by monitoring cerebral oxygenation in combination with a treatment guideline. Here, we describe (i) difference in brain injury between groups, (ii) feasibility of serial cranial ultrasound (cUS) and magnetic resonance imaging (MRI), (iii) local and central cUS assessment.Methods:Hundred and sixty-six extremely preterm infants were included. cUS was scheduled for day 1, 4, 7, 14, and 35 and at term-equivalent age (TEA). cUS was assessed locally (unblinded) and centrally (blinded). MRI at TEA was assessed centrally (blinded). Brain injury classification: no, mild/moderate, or severe.Results:Severe brain injury did not differ significantly between groups: cUS (experimental 10/80, control 18/77, P = 0.32) and MRI (5/46 vs. 3/38, P = 0.72). Kappa values for local and central readers were moderate-to-good for severe and poor-to-moderate for mild/moderate injuries. At TEA, cUS and MRI were assessed in 72 and 64%, respectively.Conclusion:There was no difference in severe brain injury between groups. Acquiring cUS and MRI according the standard operating procedures must be improved for future trials. Whether monitoring cerebral oxygenation during the first 72 h of life prevents brain injury should be evaluated in larger multicenter trials.

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Section: Discussionsupporting

confidence: 93%

Brain injury in the international multicenter randomized SafeBoosC phase II feasibility trial: cranial ultrasound and magnetic resonance imaging assessments

et al. 2015

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“…Most studies on interobserver variability using ultrasound in different diagnostic disciplines showed similar levels of agreement2, 14–18, while a few reported higher κ values2, 19. The variability in interobserver agreement in this and other studies may be explained by different levels of expertise in offline examination of 3D volumes, suboptimal quality of volumes, or insufficient clinical information.…”

Section: Discussionsupporting

confidence: 50%

Detection of intracavitary uterine pathology using offline analysis of three‐dimensional ultrasound volumes: interobserver agreement and diagnostic accuracy

Bosch

Valentin

Schoubroeck

et al. 2012

Ultrasound in Obstet & Gyne

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“…However, as surgical procedures increase reimbursements paid to hospitals, the use of interventions as an outcome variable entails little risk of underreporting, in contrast to the mere diagnoses IVH, ROP, and NEC that are liable to down-coding. Abnormal cranial ultrasound findings may give misleading results, considering the high interobserver variability in assessment of cranial ultrasound findings ( 36 , 37 ) and the poor correlation between high-grade IVH, as depicted by early cranial ultrasound, and neurodevelopmental impairment ( 37 , 38 ). The association between NEC and poor neurodevelopmental outcome appears to be confined to infants with NEC-related abdominal surgery ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Mortality and Major Morbidity of Very-Low-Birth-Weight Infants in Germany 2008–2012: A Report Based on Administrative Data

Jeschke¹,

Biermann²,

Günster³

et al. 2016

Front. Pediatr.

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BackgroundExpectant parents of very preterm infants, physicians, and policy makers require estimates for chances of survival and survival without morbidity. Such estimates should derive from a large, reliable, and contemporary data base of easily available items known at birth.ObjectiveTo determine short-term outcome and risk factors in very-low-birth-weight preterm infants based on administrative data.MethodsAnonymized routine data sets transmitted from hospital administrations to statutory health insurance companies were used to assess survival and survival free of major morbidities in a large cohort of preterm infants in Germany.ResultsAfter exclusion of infants with lethal malformations, there were 13,147 infants with a birth weight below 1,500 g admitted to neonatal care 2008–2012, of whom 1,432 infants (10.9%) died within 180 days. Estimated 180 days survival probabilities were 0.632 (95% confidence interval 0.583–0.677) for infants with 250–499 g birth weight, 0.817 (0.799–0.834) for 500–749 g, 0.931 (0.920–0.940) for 750–999 g, 0.973 (0.967–0.979) for 1,000–1,249 g, and 0.985 (0.981–0.988) for 1,250–1,499 g. Estimated probabilities for survival without major morbidity (surgically treated intraventricular hemorrhage, necrotizing enterocolitis, intestinal perforation, or retinopathy) were 0.433 (0.384–0.481) for 250–499 g, 0.622 (0.600–0.643) for 500–749 g, 0.836 (0.821–0.849) for 750–999 g, 0.938 (0.928–0.946) for 1,000–1,249 g, and 0.969 (0.964–0.974) for 1,250–1,499 g, respectively. Prediction of survival and survival without major morbidities was moderately improved by adding sex, small for gestational age, and severe or moderate congenital malformation, increasing receiver operating characteristic areas under the curve from 0.839 (0.827–0.850) to 0.862 (0.852–0.874) (survival) and from 0.827 (0.822–0.842) to 0.852 (0.846–0.863) (survival without major morbidities), respectively.ConclusionThe present analysis encourages attempts to use administrative data to investigate the association between risk factors and outcome in preterm infants.

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Interobserver variability in assessment of cranial ultrasound in very preterm infants

Cited by 19 publications

References 19 publications

Brain injury in the international multicenter randomized SafeBoosC phase II feasibility trial: cranial ultrasound and magnetic resonance imaging assessments

Brain injury in the international multicenter randomized SafeBoosC phase II feasibility trial: cranial ultrasound and magnetic resonance imaging assessments

Detection of intracavitary uterine pathology using offline analysis of three‐dimensional ultrasound volumes: interobserver agreement and diagnostic accuracy

Mortality and Major Morbidity of Very-Low-Birth-Weight Infants in Germany 2008–2012: A Report Based on Administrative Data

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