Nuchal Translucency Quality Review (NTQR) program: first one and half million results

Area of Science:

• Medical Imaging
• Prenatal Diagnostics
• Quality Assurance

Background:

• First-trimester nuchal translucency (NT) measurement is a critical component of prenatal screening for chromosomal abnormalities.
• The Nuchal Translucency Quality Review (NTQR) program aims to standardize and improve the quality of NT measurements.
• Provider performance in NT measurement can significantly impact screening accuracy.

Purpose of the Study:

• To evaluate the performance of first-trimester nuchal translucency (NT) measurement providers within the NTQR program.
• To identify factors influencing variability in NT measurement performance among physician-sonologists and sonographers.

Main Methods:

• The NTQR program monitored provider performance using median multiple of the normal median (MoM) for crown-rump length (CRL) within a 0.9-1.1 MoM range.
• Standard deviation (SD) of log10 MoM and regression slope of NT on CRL were also assessed.
• Performance indicators were analyzed across 4710 providers and 2150 ultrasound units.

Main Results:

• Among 1,485,944 scans, the median provider NT-MoM was 0.913, with only 55% achieving the target range.
• A tendency towards under-measurement was observed, with significant variations in NT-MoM, SD, and slope among providers.
• Provider experience, including time in the NTQR program and annual scan volume, correlated with improved performance.

Conclusions:

• Considerable variability in NT measurement performance persists among providers, even with extensive training and credentialing.
• Experienced providers demonstrated performance closer to expected values, suggesting a learning curve effect.
• Continuous quality monitoring and targeted interventions are necessary to minimize performance variations and enhance screening accuracy.