Rationale and Design of the FREQUENCY Study: The Fetal Cardiac Registry of Québec to Improve Resource Utilization in Fetal Cardiology

Noël, C.; Gagnon, M. Karen J.; Cardinal, Mikhail-Paul; Guertin, Olivier; Déry, Antoine; Têtu, Cassandre; Vanasse, Alain; Roy-Lacroix, Marie-Ève; Poder, Thomas G.; Marelli, Ariane J.; Cavallé‐Garrido, Tíscar; Vaujois, Laurence; Bigras, Jean‐Luc; Dallaire, Frédéric

doi:10.1016/j.jogc.2018.10.009

Cited by 7 publications

(9 citation statements)

References 24 publications

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“…Here, we wish to bring forth preliminary results of the FREQUENCY (Fetal Cardiac Registry of Qu ebec to Improve Resource Utilization in Fetal Cardiology) study, a population-based retrospective cohort study to assess the performance of prenatal congenital heart disease (CHD) screening in Qu ebec. 1 Although these results are preliminary, 2 they show that scaling down the rate of FE when the second-trimester ultrasound is normal can be done without a significant increase in undetected severe CHD.…”

Section: To the Editormentioning

confidence: 87%

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Considerations for Scaling Down Fetal Echocardiography During the COVID-19 Pandemic

Cardinal¹,

Poder²,

Roy-Lacroix³

et al. 2020

Canadian Journal of Cardiology

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Section: To the Editormentioning

confidence: 87%

“…The full protocol was previously published. 1 Briefly, we merged data from all FE performed in Qu ebec from 2007 to 2015 with administrative health care data of all mother-child dyads in Qu ebec during the same period. The cohort included 698,984 pregnancies.…”

Section: To the Editormentioning

confidence: 99%

Considerations for Scaling Down Fetal Echocardiography During the COVID-19 Pandemic

Cardinal¹,

Poder²,

Roy-Lacroix³

et al. 2020

Canadian Journal of Cardiology

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“…To substantiate this observation, we initiated 2 parallel research projects. First, we undertook the FREQUENCY study, 10 a population-based retrospective cohort study evaluating the actual performance of prenatal screening in the province of Quebec. The study is ongoing.…”

Section: Discussionmentioning

confidence: 99%

“…In 2018, we set up the Fetal Cardiac Registry of Quebec to Improve Resource Utilization in Fetal Cardiology (FREQUENCY) study, a large retrospective population-based study that aims to assess the performance of prenatal CHD screening in Quebec on > 650,000 mother–child dyads. 10 We used the preliminary results 11 , 12 of the FREQUENCY study to feed the initial assumption of our theoretical models: a prevalence of severe CHD of 1.82/1000 pregnancies, and a prevalence of high-risk pregnancies of 19.1/1000. The risk ratio of CHD in high-risk pregnancies cannot be calculated with the FREQUENCY study data.…”

Section: Methodsmentioning

confidence: 99%

The Mathematical Limitations of Fetal Echocardiography as a Screening Tool in the Setting of a Normal Second-Trimester Ultrasound

et al. 2021

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“…We previously published details on the study protocol. 9 In Quebec, there is universal health care insurance that covers all pregnancy care and follow-ups, including second-trimester ultrasound, fetal cardiology referrals, FE, health care costs for delivery and all health care costs relating to the offspring.…”

Section: Methodsmentioning

confidence: 99%

Incremental Detection of Severe Congenital Heart Disease by Fetal Echocardiography Following a Normal Second Trimester Ultrasound Scan in Québec, Canada

Cardinal

Gagnon

Têtu

et al. 2022

Circ: Cardiovascular Imaging

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BACKGROUND: The benefit of fetal echocardiograms (FE) to detect severe congenital heart diseases (SCHD) in the setting of a normal second-trimester ultrasound is unclear. We aimed to assess whether the increase in SCHD detection rates when FE are performed for risk factors in the setting of a normal ultrasound was clinically significant to justify the resources needed. METHODS: This is a multicenter, population-based, retrospective cohort study, including all singleton pregnancies and offspring in Quebec (Canada) between 2007 and 2015. Administrative health care data were linked with FE clinical data to gather information on prenatal diagnosis of CHD, indications for FE, outcomes of pregnancy and offspring, postnatal diagnosis of CHD, cardiac interventions, and causes of death. The difference between the sensitivity to detect SCHD with and without FE for risk factors was calculated using generalized estimating equations with a noninferiority margin of 5 percentage points. RESULTS: A total of 688 247 singleton pregnancies were included, of which 30 263 had at least one FE. There were 1564 SCHD, including 1071 that were detected prenatally (68.5%). There were 12 210 FE performed for risk factors in the setting of a normal second-trimester ultrasound, which led to the detection of 49 additional cases of SCHD over 8 years. FE referrals for risk factors increased sensitivity by 3.1 percentage points (95% CI, 2.3–4.0; P <0.0001 for noninferiority). CONCLUSIONS: In the setting of a normal second-trimester ultrasound, adding a FE for risk factors offered low incremental value to the detection rate of SCHD in singleton pregnancies. The current ratio of clinical gains versus the FE resources needed to screen for SCHD in singleton pregnancies with isolated risk factors does not seem favorable. Further studies should evaluate whether these resources could be better allocated to increase SCHD sensitivity at the ultrasound level, and to help decrease heterogeneity between regions, institutions and operators.

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Rationale and Design of the FREQUENCY Study: The Fetal Cardiac Registry of Québec to Improve Resource Utilization in Fetal Cardiology

Cited by 7 publications

References 24 publications

Considerations for Scaling Down Fetal Echocardiography During the COVID-19 Pandemic

Considerations for Scaling Down Fetal Echocardiography During the COVID-19 Pandemic

The Mathematical Limitations of Fetal Echocardiography as a Screening Tool in the Setting of a Normal Second-Trimester Ultrasound

Incremental Detection of Severe Congenital Heart Disease by Fetal Echocardiography Following a Normal Second Trimester Ultrasound Scan in Québec, Canada

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