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Poor agreement between operators on grading of the placenta

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Author(s)
Moran, Mary 
Ryan, John 
Higgins, Mary 
Brennan, Patrick 
McAuliffe, Fionnuala M. 
Uri
http://hdl.handle.net/10197/7664
Date Issued
January 2011
Date Available
02T11:37:30Z June 2016
Abstract
Abnormal placental grading is associated with poor pregnancy outcome. The aim of this study was to measure intra- and interobserver variability in placental grading. Five expert sonographers independently graded 90 images on two occasions, each viewing separated by 1 week. A number of measures were employed to standardise assessment and minimise potential for variation: prior agreement was established between observers on the classifications for placental grading; a controlled viewing laboratory was used for all viewings; ambient lighting was optimal and monitors were calibrated to the GSDF standard. Kappa (κ) analysis was used to measure observer agreement. Substantial variations between individuals' scores were observed. A mean κ-value of 0.34 (range from 0.19 to 0.50) indicated fair interobserver agreement over the two occasions and only nine of the 90 images were graded the same by all five observers. Intraobserver agreement had a moderate mean κ-value of 0.52, with individual comparisons ranging from 0.45 to 0.66. This study demonstrates that, despite standardised viewing conditions, Grannum grading of the placenta is not a reliable technique even among expert observers. The need for new methods to assess placental health is required and work is ongoing to develop 2D and 3D software-based methods.
Type of Material
Journal Article
Publisher
Taylor and Francis
Journal
Journal of Obstetrics and Gynaecology
Volume
31
Issue
1
Start Page
24
End Page
28
Copyright (Published Version)
2011 Informa UK, Ltd.
Keywords
  • Observer agreement

  • Placental health

  • Ultrasound assessment...

DOI
10.3109/01443615.2010.522266
Language
English
Status of Item
Peer reviewed
This item is made available under a Creative Commons License
https://creativecommons.org/licenses/by-nc-nd/3.0/ie/
Owning collection
Medicine Research Collection
Scopus© citations
16
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Jan 30, 2023
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