title: Intra- and interoperator repeatability of the nuchal translucency measurement.
abstract: OBJECTIVE
  The aim of this study was to assess the repeatability of nuchal translucency measurement by well-trained sonographers either experienced or inexperienced with the measurement.
  
  
  METHODS
  The nuchal translucency was measured three times by two out of nine operators in 161 pregnant women attending two teaching hospitals. Intra-operator and inter-operator variation was assessed by calculating the standard deviation (SD). Intraclass Correlation Coefficients (ICC) with a 95% lower confidence limit (95% CL) were calculated for each operator and for pairs of operators. Intra- and inter-operator kappa statistics were calculated, after dichotomising the results into a nuchal translucency smaller or larger than 3 mm.
  
  
  RESULTS
  The SD of intra-operator difference was 0.35 mm. The intra-operator repeatability showed ICCs varying from 0.83 to 0.95 for the experienced operators and from 0.47 to 0.83 for the inexperienced. The SD of inter-operator differences was 0.56 mm, 0.46 mm and 0.44 mm, based on one, two and three measurements, respectively. The inter-operator repeatability showed a variation in ICC from 0.74 to 0.95 in pairs of experienced sonographers to 0.51 in one pair inexperienced with the measurement. The kappa value expressing the intra and inter-operator repeatability as being > 3 mm or < 3 mm was 0.88 and 0.85, respectively.
  
  
  CONCLUSIONS
  This study supports the finding that the nuchal translucency measurement is reproducible, as long as it is performed by sonographers well trained in the technique of this measurement.
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, Tilburg, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Pajkrt
authors.forename: B W
authors.initials: BW
authors.lastname: Mol
authors.forename: K
authors.initials: K
authors.lastname: Boer
authors.forename: A P
authors.initials: AP
authors.lastname: Drogtrop
authors.forename: P M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: C M
authors.initials: CM
authors.lastname: Bilardo
mesh_terms: D004314:Down Syndrome / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D009333:Neck / Q000000981:diagnostic imaging / Q000196:embryology*; D015588:Observer Variation; D011247:Pregnancy; D015203:Reproducibility of Results; D016216:Ultrasonography, Prenatal