Premium
Learning curve for lung area to head circumference ratio measurement in fetuses with congenital diaphragmatic hernia
Author(s) -
CruzMartinez R.,
Figueras F.,
MorenoAlvarez O.,
Martinez J. M.,
Gomez O.,
HernandezAndrade E.,
Gratacos E.
Publication year - 2010
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.7577
Subject(s) - cusum , medicine , congenital diaphragmatic hernia , learning curve , diaphragmatic breathing , head circumference , fetal head , lung , cohort , fetus , nuclear medicine , pediatrics , birth weight , statistics , pregnancy , mathematics , pathology , alternative medicine , management , biology , economics , genetics
Objective To assess the learning curve for the fetal lung area to head circumference ratio (LHR) calculation in fetuses with congenital diaphragmatic hernia (CDH). Methods Three trainees with the theoretical knowledge, but without prior experience in the LHR measurement, were selected. Each trainee and one experienced examiner measured the observed to expected (O/E)‐LHR in the lung contralateral to the side of the hernia by two methods—manual tracing of lung borders and multiplication of the longest diameters—in a cohort of 95 consecutive CDH fetuses. The average difference between the three trainees and the expert in the O/E‐LHR measurement was calculated. A difference below 10% was considered to indicate an accurate measurement. The average learning curve was delineated using cumulative sum analysis (CUSUM). Results The CUSUM plots demonstrate that the learning curve was achieved by 77 and 72 tests performed for the area obtained by the manual‐tracing and multiplication‐of‐the‐longest‐diameter methods, respectively. Conclusion The minimum number of scans required for an inexperienced trainee to become competent in examining the LHR is on average 70. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.