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Interpretation of biophysical profiles by nurses and physicians
C L Gegor1, L L Paine, K Costigan
1Nurse-Midwifery Services, Johns Hopkins University School of Medicine, Baltimore, MD.
Objective:
To determine the agreement between nurse and physician interpretation of biophysical profile scores.
Design:
A prospective evaluation of videotaped biophysical profiles was independently scored by four nurse and four physician interpreters and compared to that of an expert physician.
Setting:
The fetal assessment center of a large tertiary-care center; study included women from public and private practices.
Patients:
Twenty-three women with high-risk pregnancies who were regularly scheduled for a biophysical profile. Women pregnant with multiple fetuses or whose fetuses were less than 28 weeks' gestational age or had severe fetal anomalies were excluded.
Main Outcome Measure:
The proportion of agreement between the physicians and nurses and the physician expert was calculated for each biophysical profile criterion.
Results:
The kappa statistic was used to evaluate the proportion of agreement with the "gold standard." When compared with the expert, physicians showed 60% moderate or substantial agreement, and the nurses showed 80% moderate or substantial agreement.
Conclusions:
Nurses' interpretations of biophysical profiles were at least as reliable as physicians' when compared with an expert reviewer.