title: [Modified Tei index, interobserver agreement related to sonographer experience level].
abstract: BACKGROUND
  increasing numbers of studies that attempt to introduce the Tei index as part of fetal assessment in different conditions (corrected diaphragmatic hernia, supraventricular tachycardia, fetal inflammatory response, cystic adenomatoid disease, fetal-fetal transfusion, etc.).
  
  
  OBJECTIVE
  To determine the interobserver agreement in measuring the modified Tei index in observers with different levels of experience in obstetric ultrasound.
  
  
  METHODS
  Three observers were classified according to their level of experience (A, B and C) and selected 65 images to analyze the modified Tei index interobserver agreement. If all observers felt unanimously that were eligible for analysis, the image was selected. Each observer made the measurements independently. Once complete measurements, archived images and data were analyzed.
  
  
  RESULTS
  The lowest variability of the modified Tei index was among the observers A/C (standard deviation of the differences of 27% versus 30% (B/C), versus. 40% (A/B). The correlation coefficient interclass of the three observers together was a regular on the scale of Landis and Koch, and substantial for observer A. The lowest variability of individual parameters was for ejection time. Interobserver variability was less gradually from first to fourth month observations.
  
  
  CONCLUSIONS
  It has not been able to replicate the level of interobserver variability suggested in literature, by the effects of the learning curve in the procurement and selection of images. The modified Tei index interobserver variability was not found influenced by the level of operator experience in this context, but is considered not conclusive until obtain better evidence.
authors.affiliation: Centro de Diagnóstico Fetal Integral, León, Guanajuato, México. garciamaynor@yahoo.com.mx
authors.forename: Maynor Alfonso
authors.initials: MA
authors.lastname: García-López
authors.forename: M de la Luz
authors.initials: Mde L
authors.lastname: Bermúdez-Rojas
authors.forename: Elma
authors.initials: E
authors.lastname: Díaz-Aguiar
mesh_terms: D000328:Adult; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging* / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D059032:Learning Curve; D009200:Myocardial Contraction; D015588:Observer Variation; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D055815:Young Adult