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

d practices with long-term experience or in general hospitals with certified examiners. If a finding requires further clarification or if specific treatment is needed for the mother or child, level 3 facilities, mainly university clinics, are available.

German Federal Joint Committee revises maternity guidelines

In order to be able to review the German ultrasound screening procedures (which have been established for over 10 years and are embedded in the maternity guidelines) and to adapt them to the current state of knowledge, the Federal Joint Committee (G-BA) first commissioned IQWiG to assess the detection rates for major foetal abnormalities with regard to examiner qualifications and device quality. This report therefore deals exclusively with test accuracy. Issues concerning parental information, consent, and medical counselling, which are also of major relevance in this type of screening, are investigated in a separate report, which the G-BA commissioned on 15 May 2008.

Test accuracy varies strongly

A total of 60 studies eligible for analysis were found in the literature search. These studies repeatedly indicated that examiners and devices were important factors in the outcome quality of screening. However, test accuracy between studies varied strongly; the causes of this variation were not clear. In addition, all of these studies originated from abroad and mainly referred to the health care levels 2 and 3 noted above. It is therefore questionable whether the results are transferable to the German setting, where the initial screening test takes place mainly on level 1. On this basis, the question cannot be answered as to which minimum standards need to be fulfilled by examiners and technical equipment in order to achieve sufficiently high detection rates. Relevant studies on the German - or at least a comparable - screening programme are completely lacking.

In view of this deficit, IQWiG suggests co
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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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