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Re: Parameter charts From: Edward Zabrek, M.D., F.A.C.O.G. (stork@flash.net) Thu Dec 4 21:41:15 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Terry J. DuBose: "Frog2688@aol.com: [soundadvice] New England Journal of Medicine" Previous message: Victoria Alderman: "TA vs. TV for Cervical Length" In reply to: JT & JL Tomko: "Parameter charts" Next in thread: Terry J. DuBose: "Re: Parameter charts" I believe that standards are only as good as the test population from which they are derived. This is particularly true with an Ob population. As we all know, the population of pregnant moms living in Denver will show a much lower EFW as a "normal standard" than those living in NYC or nearly any other city at sea level. I believe that a more appropriate model for fetal growth is the Ivar Rosavik or Russell Deter model that allows each fetus to determine his/her own growth curves with serial sonograms. This also takes into account the constitutionally large (not macrosomic) or small (not growth restricted) fetuses. It is a much more accurate model for growth and eliminates many of the errors of standardized curves. There is much variance both with interuser and intrauser. It is difficult to get the exact same measurements in the exact same plane twice in row. So there begins your problems. I standards are only as good as the people who truly know and understand their derivation. They are, however, a necessary evil, since we do not at this time have anything else (with our current technologies) that is any better. -- Edward Zabrek, M.D., F.A.C.O.G. stork@flash.net At 05:37 PM 12/3/97 -0600, you wrote: >Sonographers and others, > >I have a question concerning parameters of measurement. > >1. For EFW percentile charts.....which is the most accurate chart that you >have found. > >2. Is anyone else utilizing gynecology charts for endometrial thickness? >The hospital has an odd chart and I am not sure where it was gathered from >but the parameters appear to be calling a ton of false positives when this >chart is implemented. I am using the following.. premenopausal 15 mm >thickness no matter what phase the cycle is in. Postmenopausal without HRT >use 8 mm and Postmenopausal with HRT use as 10 mm cutoffs. Cannot tell you >how many heavy conversations with one radiologist (as he is sticking to this >chart like the superglue) when he calls a 12 mm lining abnormal in a >midcycle premenopausal female. I suppose the downside of reference >parameters...which leads me to ask why don't we have a standard sonography >reference range. > >3. I am utilizing ovarian volume charts as well as uterine volume charts to >help define normal from abnormal. Volumes on premenopausal ovaries are 15 >cc as top normal. What are your cut-offs. > >I was hoping that all of gyn and ob sonography could stay standard with the >charts. There is so much variance in the data available and think it would >be more beneficial to set a standard of reference. At least with lab data >you know if the WBC is > 10,000 there is a suspicion...but in sonography..I >think we don't have such a defining process. > >Anyone want to add their thoughts on this? > Next message: Terry J. DuBose: "Frog2688@aol.com: [soundadvice] New England Journal of Medicine" Previous message: Victoria Alderman: "TA vs. TV for Cervical Length" In reply to: JT & JL Tomko: "Parameter charts" Next in thread: Terry J. DuBose: "Re: Parameter charts"

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