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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.
Summary
Nurses demonstrated higher agreement than physicians in interpreting biophysical profile scores against an expert standard. This suggests nurses
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Diagnostic Imaging
Background:
- The biophysical profile (BPP) is a common antenatal assessment tool.
- Accurate interpretation of BPP components is crucial for fetal well-being.
- Variability in BPP interpretation may exist among healthcare providers.
Purpose of the Study:
- To assess the agreement between nurse and physician interpretations of biophysical profile scores.
- To compare the reliability of nurse versus physician BPP interpretations against an expert standard.
Main Methods:
- Prospective evaluation of videotaped biophysical profiles.
- Independent scoring by four nurses and four physicians.
- Comparison of interpreter scores to an expert physician's assessment.
- Calculation of agreement proportions using the kappa statistic.
Main Results:
- Physicians showed 60% moderate or substantial agreement with the expert reviewer.
- Nurses demonstrated 80% moderate or substantial agreement with the expert reviewer.
- The kappa statistic indicated higher agreement for nurses compared to physicians.
Conclusions:
- Nurses' interpretations of biophysical profiles are as reliable as, if not more reliable than, physicians' interpretations.
- Findings support the significant role of nurses in accurate BPP assessment.
- This study highlights the importance of standardized BPP interpretation protocols.