Interobserver and intraobserver reliability of the NICHD 3-Tier Fetal Heart Rate Interpretation System

Sean C. Blackwell; William A. Grobman; Leah Antoniewicz; Maria Hutchinson; Cynthia Gyamfi Bannerman

doi:10.1016/j.ajog.2011.06.086

Interobserver and intraobserver reliability of the NICHD 3-Tier Fetal Heart Rate Interpretation System

Sean C. Blackwell^*, William A. Grobman, Leah Antoniewicz, Maria Hutchinson, Cynthia Gyamfi Bannerman

^*Corresponding author for this work

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

99 Scopus citations

Abstract

OBJECTIVE: Our purpose was to test the reliability of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 3-Tier Fetal Heart Rate (FHR) classification system. STUDY DESIGN: Individual 15- to 20-minute FHR segments (n=154) were independently reviewed without clinical data by 3 maternal-fetal medicine examiners and classified by NICHD category (I, II, III). RESULTS: Interobserver reliability was moderate (kappa 0.45) and varied by NICHD category (category I moderate [kappa 0.48], category II moderate [kappa 0.44], and category III poor [kappa 0.0]). The intraobserver agreement ranged from substantial to perfect (kappa 0.74-1.0). CONCLUSION: Interobserver agreement of 3-Tier FHR classification System was moderate for NICHD categories I and II. Agreement for category III tracings was poor mainly due to lack of agreement regarding absent vs minimal variability.

Original language	English (US)
Pages (from-to)	378.e1-378.e5
Journal	American journal of obstetrics and gynecology
Volume	205
Issue number	4
DOIs	https://doi.org/10.1016/j.ajog.2011.06.086
State	Published - Oct 2011

Keywords

Electronic fetal monitoring
Eunice Kennedy Shriver National Institute of Child Health and Human Development classification system
Fetal heart rate
Fetal heart rate interpretation
Reliability

ASJC Scopus subject areas

Obstetrics and Gynecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ajog.2011.06.086

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title = "Interobserver and intraobserver reliability of the NICHD 3-Tier Fetal Heart Rate Interpretation System",

abstract = "OBJECTIVE: Our purpose was to test the reliability of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 3-Tier Fetal Heart Rate (FHR) classification system. STUDY DESIGN: Individual 15- to 20-minute FHR segments (n=154) were independently reviewed without clinical data by 3 maternal-fetal medicine examiners and classified by NICHD category (I, II, III). RESULTS: Interobserver reliability was moderate (kappa 0.45) and varied by NICHD category (category I moderate [kappa 0.48], category II moderate [kappa 0.44], and category III poor [kappa 0.0]). The intraobserver agreement ranged from substantial to perfect (kappa 0.74-1.0). CONCLUSION: Interobserver agreement of 3-Tier FHR classification System was moderate for NICHD categories I and II. Agreement for category III tracings was poor mainly due to lack of agreement regarding absent vs minimal variability.",

keywords = "Electronic fetal monitoring, Eunice Kennedy Shriver National Institute of Child Health and Human Development classification system, Fetal heart rate, Fetal heart rate interpretation, Reliability",

author = "Blackwell, {Sean C.} and Grobman, {William A.} and Leah Antoniewicz and Maria Hutchinson and Bannerman, {Cynthia Gyamfi}",

year = "2011",

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AU - Blackwell, Sean C.

AU - Grobman, William A.

AU - Antoniewicz, Leah

AU - Hutchinson, Maria

AU - Bannerman, Cynthia Gyamfi

PY - 2011/10

Y1 - 2011/10

N2 - OBJECTIVE: Our purpose was to test the reliability of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 3-Tier Fetal Heart Rate (FHR) classification system. STUDY DESIGN: Individual 15- to 20-minute FHR segments (n=154) were independently reviewed without clinical data by 3 maternal-fetal medicine examiners and classified by NICHD category (I, II, III). RESULTS: Interobserver reliability was moderate (kappa 0.45) and varied by NICHD category (category I moderate [kappa 0.48], category II moderate [kappa 0.44], and category III poor [kappa 0.0]). The intraobserver agreement ranged from substantial to perfect (kappa 0.74-1.0). CONCLUSION: Interobserver agreement of 3-Tier FHR classification System was moderate for NICHD categories I and II. Agreement for category III tracings was poor mainly due to lack of agreement regarding absent vs minimal variability.

AB - OBJECTIVE: Our purpose was to test the reliability of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 3-Tier Fetal Heart Rate (FHR) classification system. STUDY DESIGN: Individual 15- to 20-minute FHR segments (n=154) were independently reviewed without clinical data by 3 maternal-fetal medicine examiners and classified by NICHD category (I, II, III). RESULTS: Interobserver reliability was moderate (kappa 0.45) and varied by NICHD category (category I moderate [kappa 0.48], category II moderate [kappa 0.44], and category III poor [kappa 0.0]). The intraobserver agreement ranged from substantial to perfect (kappa 0.74-1.0). CONCLUSION: Interobserver agreement of 3-Tier FHR classification System was moderate for NICHD categories I and II. Agreement for category III tracings was poor mainly due to lack of agreement regarding absent vs minimal variability.

KW - Electronic fetal monitoring

KW - Eunice Kennedy Shriver National Institute of Child Health and Human Development classification system

KW - Fetal heart rate

KW - Fetal heart rate interpretation

KW - Reliability

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Interobserver and intraobserver reliability of the NICHD 3-Tier Fetal Heart Rate Interpretation System

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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