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To develop a quantitative quality control process of nuchal translucency (NT) at 11 to 14 weeks of gestation based on the mixture model (1), based on the analysis of the corresponding distribution of the likelihood ratio (LHR).
Based on the published mixture-model for NT measurement at first trimester (1), we simulated the expected distribution of NT and corresponding LHR. This approach was then tested for the quality control of 15 048 NT measurements performed by four FMF trained operators. The new quality control approach based on LHR was compared to existing processes based on NT plots, median of MoMs and analysis of the 95(th) percentile
Each operator contributed for 2176 to 4730 examinations. The median, 5(th) and 95(th) percentile of NT values ranged from 1.4 to 1.6mm, 1.0mm and 2.2 to 2.6 mm respectively. Median of NT MoM ranged from 0.83 to 0.95 MoM. Analysis of the distribution of NT measurements confirmed departure from the assumption of the Delta-NT and MoM NT models. Analysis of LHR distributions demonstrated a significant difference between observed and expected distributions for all operators (p<10(-4)).
LHR-based quality control process is feasible at 11-14 weeks. Because it is less sensitive to measurements' bias around the critical area of the 95(th) percentile, its use should be encouraged Copyright (c) 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Obstetrics and maternal-fetal medicine, GHU Necker-Enfants Malades, AP-HP, Université Paris Descartes, France.
This article was published in the following journal.
To assess the utility of a detailed early fetal anatomy scan prior to karyotyping in the management of pregnancies with an increased nuchal translucency (NT).
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A prenatal ultrasonic measurement of the thickness or translucent area below the SKIN in the back of the fetal NECK, or nape of the neck, during the first 11-14 weeks of gestation (PREGNANCY TRIMESTER, FIRST). Abnormal thickness or nuchal translucent measurements resulting from fluid collection, is associated with increased risks of CHROMOSOME ABNORMALITIES. (Nicolaides et al., 1992)
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
A system for verifying and maintaining a desired level of quality in a product or process by careful planning, use of proper equipment, continued inspection, and corrective action as required. (Random House Unabridged Dictionary, 2d ed)
The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.
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