Is Grannum Grading of the Placenta Reproducible?

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Title: Is Grannum Grading of the Placenta Reproducible?
Authors: Moran, Mary
Ryan, John
Brennan, Patrick
Higgins, Mary
McAuliffe, Fionnuala M.
Permanent link: http://hdl.handle.net/10197/7660
Date: 12-Mar-2009
Abstract: Current ultrasound assessment of placental calcification relies on Grannum grading. The aim of this study was to assess if this method is reproducible by measuring inter- and intra-observer variation in grading placental images, under strictly controlled viewing conditions. Thirty placental images were acquired and digitally saved. Five experienced sonographers independently graded the images on two separate occasions. In order to eliminate any technological factors which could affect data reliability and consistency all observers reviewed images at the same time. To optimise viewing conditions ambient lighting was maintained between 25-40 lux, with monitors calibrated to the GSDF standard to ensure consistent brightness and contrast. Kappa (κ) analysis of the grades assigned was used to measure inter- and intra-observer reliability. Intra-observer agreement had a moderate mean κ-value of 0.55, with individual comparisons ranging from 0.30 to 0.86. Two images saved from the same patient, during the same scan, were each graded as I, II and III by the same observer. A mean κ-value of 0.30 (range from 0.13 to 0.55) indicated fair inter-observer agreement over the two occasions and only one image was graded consistently the same by all five observers. The study findings confirmed the lack of reproducibility associated with Grannum grading of the placenta despite optimal viewing conditions and highlight the need for new methods of assessing placental health in order to improve neonatal outcomes. Alternative methods for quantifying placental calcification such as a software based technique and 3D ultrasound assessment need to be explored.
Type of material: Journal Article
Publisher: SPIE
Copyright (published version): 2009 SPIE
Keywords: Placental healthUltrasound assessmentObserver variation
DOI: 10.1117/12.810993
Language: en
Status of Item: Peer reviewed
Is part of: Sahiner, B. and Manning, D.J. Proceedings SPIE 7263: Medical Imaging 2009: Image Perception, Observer Performance, and Technology Assessment
Appears in Collections:Medicine Research Collection

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