Intra-observer and inter-observer reliability of the pulsatility index calculated from pulsed Doppler flow velocity waveforms in three fetal vessels. 1993

S A Scherjon, and J H Kok, and H Oosting, and H A Zondervan
Academic Medical Centre, Department of Obstetrics & Gynaecology, Amsterdam, The Netherlands.

OBJECTIVE Study of the intra observer and inter observer reliability of the pulsatility index, calculated from pulsed Doppler recordings of three fetal vessels. METHODS Flow velocity waveforms (FVW) were recorded from the umbilical artery, the fetal descending aorta and the fetal internal carotid artery. Intra-observer reliability was assessed in six fetuses; ten repeated measurements were performed by one observer. Inter-observer reliability was studied in 14 fetuses; two observers performed two repeated measurements in each fetus. METHODS A tertiary referral hospital. METHODS High risk pregnancies with a gestational age ranging from 29 to 42 weeks. METHODS Analysis of variance with repeated measurements and a graphical method were used for data analysis. Intra-observer repeatability was expressed as Intraclass Correlation Coefficient (IntraCC). Inter-observer agreement was expressed as Interclass Correlation Coefficient (InterCC). RESULTS IntraCC for umbilical artery, descending aorta and internal carotid artery were 0.91, 0.78, and 0.54, respectively. InterCC values for these vessels were 0.39, 0.45 and 0.34, respectively. No systematic differences between the two observers except for the fetal descending aorta, were apparent. IntraCC decreased remarkable when fetuses with absent end diastolic velocities were excluded from the analysis. CONCLUSIONS The pulsatility index (PI) used for fetal measurements has a poor reliability. This is of serious concern when clinical use of FVW measurements is considered as a diagnostic tool.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D002343 Carotid Artery, Internal Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose. Arteries, Internal Carotid,Artery, Internal Carotid,Carotid Arteries, Internal,Internal Carotid Arteries,Internal Carotid Artery
D005260 Female Females
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001013 Aorta, Thoracic The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA. Aorta, Ascending,Aorta, Descending,Aortic Arch,Aortic Root,Arch of the Aorta,Descending Aorta,Sinotubular Junction,Ascending Aorta,Thoracic Aorta,Aortic Roots,Arch, Aortic,Ascending Aortas,Junction, Sinotubular,Root, Aortic,Sinotubular Junctions
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D014469 Umbilical Arteries Specialized arterial vessels in the umbilical cord. They carry waste and deoxygenated blood from the FETUS to the mother via the PLACENTA. In humans, there are usually two umbilical arteries but sometimes one. Arteries, Umbilical,Artery, Umbilical,Umbilical Artery
D015588 Observer Variation The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material). Bias, Observer,Interobserver Variation,Intraobserver Variation,Observer Bias,Inter-Observer Variability,Inter-Observer Variation,Interobserver Variability,Intra-Observer Variability,Intra-Observer Variation,Intraobserver Variability,Inter Observer Variability,Inter Observer Variation,Inter-Observer Variabilities,Inter-Observer Variations,Interobserver Variabilities,Interobserver Variations,Intra Observer Variability,Intra Observer Variation,Intra-Observer Variabilities,Intra-Observer Variations,Intraobserver Variabilities,Intraobserver Variations,Observer Variations,Variabilities, Inter-Observer,Variabilities, Interobserver,Variabilities, Intra-Observer,Variabilities, Intraobserver,Variability, Inter-Observer,Variability, Interobserver,Variability, Intra-Observer,Variability, Intraobserver,Variation, Inter-Observer,Variation, Interobserver,Variation, Intra-Observer,Variation, Intraobserver,Variation, Observer,Variations, Inter-Observer,Variations, Interobserver,Variations, Intra-Observer,Variations, Intraobserver,Variations, Observer

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