Document Detail


Electronic fetal monitoring as a public health screening program: the arithmetic of failure.
MedLine Citation:
PMID:  21099609     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Electronic fetal monitoring has failed as a public health screening program. Nevertheless, most of the four million low-risk women giving birth in the United States each year continue to undergo this screening. The failure of this program should have been anticipated and thus avoided had the accepted principles of screening been considered before its introduction. All screening tests have poor positive predictive value when searching for rare conditions such as fetal death in labor or cerebral palsy. This problem is aggravated when the screening test does not have good validity as is the case with electronic fetal monitoring. Because of low-prevalence target conditions and mediocre validity, the positive predictive value of electronic fetal monitoring for fetal death in labor or cerebral palsy is near zero. Stated alternatively, almost every positive test result is wrong. To avoid such costly errors in the future, the prerequisites for any screening program must be fulfilled before the program is begun.
Authors:
David A Grimes; Jeffrey F Peipert
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Publication Detail:
Type:  Editorial    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  116     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-04     Revised Date:  2011-05-03    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1397-400     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Cardiotocography*
Cerebral Palsy / diagnosis
False Positive Reactions
Female
Fetal Death / diagnosis
Fetal Monitoring*
Humans
Infant, Newborn
Neonatal Screening*
Predictive Value of Tests
Pregnancy
Risk Factors
Sensitivity and Specificity
Comments/Corrections
Comment In:
Obstet Gynecol. 2011 Apr;117(4):986; author reply 986-7   [PMID:  21422874 ]
Obstet Gynecol. 2011 Mar;117(3):730; author reply 730-1   [PMID:  21343780 ]
Obstet Gynecol. 2011 Mar;117(3):731; author reply 731-2   [PMID:  21343782 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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