Interpretation of Biophysical Profiles by Nurses and Physicians

Abstract

To determine the agreement between nurse and physician interpretation of biophysical profile scores. Design : A prospective evaluation of videotaped biophysical profiles was independently scored by four nurse and four physician interpreters and compared to that of an expert physician. Setting : The fetal assessment center of a large tertiary-care center; study included women from public and private practices. Patients : Twenty-three women with high-risk pregnancies who were regularly scheduled for a biophysical profile. Women pregnant with multiple fetuses or whose fetuses were less than 28 weeks' gestational age or had severe fetal anomalies were excluded. Main Outcome Measure : The proportion of agreement between the physicians and nurses and the physician expert was calculated for each biophysical profile criterion. Results : The kappa statistic was used to evaluate the proportion of agreement with the “gold standard.” When compared with the expert, physicians showed 60% moderate or substantial agreement, and the nurses showed 80% moderate or substantial agreement. Conclusions : Nurses' interpretations of biophysical profiles were at least as reliable as physicians' when compared with an expert reviewer.