Cumulative sum plots in first-trimester nuchal translucency quality assurance

doi:10.3877/cma.j.issn.1672-6448.2020.07.015

Abstract

Abstract:

Objective

To evaluate the quality assurance of fetal nuchal translucency (NT) in the first trimester by cumulative sum (CUSUM) plots.

Methods

Based on the reference range of median NT, the median of the NT MoM distribution and standard deviation (SD) were determined. CUSUM plots were created to assess whether there was an over- or under-estimation of NT measurement for each sonographer. An NT image scoring system was established to testify the results analyzed by CUSUM plots.

Results

The median NT MoM at our center was 1.1 mm, and SD was 0.23mm. CUSUM plots were created for NT assessment. For an experienced sonographer, 20 days of NT measurement were included for CUSUM scoring, which showed that NT on days 8 and 13 was overestimated. We then investigated all the NT images on these two days by the NT image scoring system, and the result was in agreement with CUSUM plots. When the measurement error of NT was above 1.0 mm, the median NT MoM lied outside the accepted limits by CUSUM plots. For a beginner sonographer, the results obtained by CUSUM plotswere quite similar to those obtained by the image scoring system.

Conclusion

The application of cumulative sum plots in quality assurance of nuchal translucency measurement is acceptable.

Key words: Cumulative sum, Fetal, Nuchal translucency

Xin Yang, Zhihui Li, Jin Han, Li Zhen, Min Pan, Dognzhi Li, Can Liao. Cumulative sum plots in first-trimester nuchal translucency quality assurance[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(07): 667-671.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.07.015

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I07/667

Figures/Tables 2

References 6

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超声医师/NT测量天		总例数（例）	图像评分（分）					χ ²值	P值
超声医师/NT测量天		总例数（例）	≤4	5~9	10~12	平均值	范围	χ ²值	P值
第1位	?	?	?	?	?	?	?	?	?
?	第5天（sample 5）	14	0	5	9	9.5	5~12	?	?
?	第8天（sample 8）	18	5	6	7	7.5	4~12	2.03	0.29
?	第13天（sample 13）	15	4	5	6	7.7	4~12	1.71	0.27
第2位	?	5	2	3	0	4.6	1~7	-	-

超声医师/NT测量天		总例数（例）	图像评分（分）					χ ²值	P值
超声医师/NT测量天		总例数（例）	≤4	5~9	10~12	平均值	范围	χ ²值	P值
第1位	?	?	?	?	?	?	?	?	?
?	第5天（sample 5）	14	0	5	9	9.5	5~12	?	?
?	第8天（sample 8）	18	5	6	7	7.5	4~12	2.03	0.29
?	第13天（sample 13）	15	4	5	6	7.7	4~12	1.71	0.27
第2位	?	5	2	3	0	4.6	1~7	-	-

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