title: Reliability of fetal middle cerebral artery velocity measurements: a randomized controlled trial of sonographer training.
abstract: OBJECTIVE
  The purpose of this study was to determine the reliability of fetal middle cerebral artery (MCA) peak systolic velocity (PSV) measurements at a tertiary care center and to evaluate the effect of targeted training for sonographers.
  
  
  METHODS
  Six sonographers were randomized to training modules for fetal MCA PSV or amniotic fluid volume (AFV) measurements. Six fetuses of uncomplicated pregnancies were selected for participation. Middle cerebral artery and AFV measurements were obtained before and after a training module. The intraobserver and interobserver variability (reliability) was calculated with intraclass correlation coefficients and was compared between groups.
  
  
  RESULTS
  Administration of the MCA training module increased the number of technically adequate MCA images obtained (odds ratio, 3.95; 95% confidence interval, 1.07-14.65). The intraobserver and inter-observer variability for MCA measurements was significantly reduced after the targeted training module (P = .05).
  
  
  CONCLUSIONS
  The reliability of fetal MCA PSV measurements improved after a targeted training program.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA. erin.clark@hsc.utah.edu
authors.forename: Erin A S
authors.initials: EA
authors.lastname: Clark
authors.forename: D Yvette
authors.initials: DY
authors.lastname: Lacoursiere
authors.forename: Janice L B
authors.initials: JL
authors.lastname: Byrne
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ponder
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
authors.forename: M Sean
authors.initials: MS
authors.lastname: Esplin
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology*; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000196:embryology / Q000502:physiology*; D015588:Observer Variation; D011361:Professional Competence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*