title: Single versus pairwise interpretation of cardiotochography, a comparative study from six Swedish delivery units.
abstract: OBJECTIVE
  The aim of the study was to evaluate whether interpreting CTG pairwise brings about a higher level of correctly classified CTG recordings in a non-selected population of midwives and physicians.
  
  
  METHODS
  A comparative study.
  
  
  METHODS
  Five delivery units in Stockholm and one delivery unit in Uppsala, with 1589, 3740, 3908, 4539, 6438, and 7331 deliveries in 2011, respectively.
  
  
  METHODS
  536 midwives and physicians classified one randomly selected CTG recording individually followed by a pairwise classification. The pairs consisted of two midwives (119 pairs) or one midwife and one physician (149 pairs), a total of 268 pairs.
  
  
  METHODS
  The proportion of individually correctly classified CTG recordings versus the proportion of pairwise correctly classified CTG recordings.
  
  
  RESULTS
  The proportion of individually correctly classified CTG's was 75% and the proportion of pairwise correctly classified CTG's was 80% (difference 5%, p = 0.12).
  
  
  CONCLUSIONS
  There was no statistically significant difference when CTG's were classified pairwise compared to individual classifications. The proportion of individually correctly classified CTG's was high (75%). There were differences in the proportion of correctly classified CTG recordings between the delivery units, indicating potential areas of improvement.
authors.affiliation: Karolinska Institute, Department of Clinical Science and Education, Unit of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden. Electronic address: hanna.amark@sodersjukhuset.se.
authors.forename: Hanna
authors.initials: H
authors.lastname: Åmark
authors.affiliation: Karolinska Institute, Department of Clinical Science and Education, Unit of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Millde-Luthander
authors.affiliation: Department of Obstetrics and Gynecology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Ajne
authors.affiliation: Department of Women's and Children's Health, Akademiska Sjukhuset, Uppsala, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Högberg
authors.affiliation: Karolinska Institute, Department of Clinical Science and Education, Unit of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Pettersson
authors.affiliation: Department of Clinical Sciences, Division of Obstetrics and Gynecology, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Wiklund
authors.affiliation: Karolinska Institute, Department of Clinical Science and Education, Unit of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Grunewald
mesh_terms: D015148:Cardiotocography / Q000379:methods*; D003696:Delivery Rooms / Q000592:standards; D036861:Delivery, Obstetric; D005260:Female; D006296:Health Services; D006801:Humans; D008880:Midwifery; D009774:Obstetrics / Q000379:methods*; D010820:Physicians; D011247:Pregnancy; D013548:Sweden
keywords: Cardiotocography; Cardiotocography interpretation; Fetal surveillance; Intrapartum; Pairwise interpretation