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Accuracy of ultrasound screening in pregnancy: Effects of examiner and device quality unclear
Date:6/24/2008

International studies indicate that there is an association between examiner qualifications and device quality on the one hand, and detection rates of ultrasound screening tests in pregnancy on the other. However, it is unclear which minimum preconditions must be fulfilled in order to achieve sufficiently high detection rates for major foetal abnormalities. The question also remains unanswered as to whether the association described in other health care systems also exists in the specific organisational setting (multi-level concept) of the German system, as relevant studies are lacking. This is the conclusion of a report by the German Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, which was published in June 2008 and for which an English-language summary is now available.

Screening is organised very differently on an international level

In Germany, ultrasound tests are an established procedure in health care during pregnancy. Among other things, their aim is the early detection of foetal abnormalities. In this context, the most correct evaluation possible is essential, as parents should be informed about any individual risk of severe deformity or chromosomal abnormality if they so wish. However, false positive diagnoses, which place a considerable burden upon parents, must be avoided as far as possible. Quite different concepts exist on an international level as to how to organise ultrasound screening tests in pregnancy. This applies to both the frequency and timing of the tests, as well as to the requirements for examiners and devices.

In Germany, three regular ultrasound tests are planned (one in each trimester). The German programme is organised in a decentralised manner, i.e., the tests are not only performed in specialised centres. The basic screening tests (level 1) are usually performed by office-based obstetricians. If abnormalities are detected, these are reviewed in level 2, i.e., in specialise
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Contact: Dr. Anna-Sabine Ernst
info@iqwig.de
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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