Related Experiment Video
Updated: May 10, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Online audit and feedback improve fetal second-trimester four-chamber view images: a randomised controlled trial
Suha Jaudi1, Benjamin Granger, Claire Nguyen Herpin
1Department of Obstetrics and Gynecology, Groupe Hospitalier Pitié Salpêtrière APHP and Université Paris 6, Paris, France; Collège Français d'Echographie Foetale, Montpellier, France.
Objectives:
We aimed to study the impact of online audit and feedback on fetal four-chamber view image quality.
Methods:
Ultrasonographers uploaded a set of four-chamber views from 10 consecutive screening examinations and a second set 3 months later. They were randomised to receive (group A) or not (group B) a feedback for their first set. The primary outcome was the difference in image mean score and in percentage of inadequate images between the first set and the second set, comparing the groups with and without feedback.
Results:
There were 258 ultrasonographers who completed the trial (group A: 122; group B: 136), and 5160 images were audited. In both groups, the mean score increased. In group A, it rose from 17.0 to 18.5 (p < 0.0001), and in group, B from 17.6 to 18.3 (p < 0.0001). The improvement was greater in group A than in group B (1.5 vs. 0.7, p = 0.0007). The mean percentage of inadequate images decreased in both groups. In group A, it dropped from 32% to 19% (p < 0.0001), and in group B, from 26% to 21% (p = 0.012). The decrease was greater in group A than in group B (13% vs. 5%, p = 0.007).
Conclusions:
Image quality improved following online audit, the improvement being slightly greater with feedback.
