A COMPARISON OF VISUAL AND AUTOMATED METHODS OF ANALYZING FETAL HEART-RATE TESTS

OBJECTIVES: Our objective in this study was to compare evaluation and clinical implications of visual versus computerized analysis of nonstr ess tests. METHODS: Nonstress tests of 575 high-risk patients were ana lyzed visually and by a computer using the Oxford Sonicaid System 8000 . Standard reactivity criteria were used for visual assessment; the Sy stem 8000 used an algorithm with the Dawes-Redman criteria. RESULTS: N inety-six percent of nonstress tests that met Dawes-Redman criteria we re reactive by visual analysis; 93% of reactive nonstress tests met Da wes-Redman criteria. Only 30% of tests that failed Dawes-Redman criter ia were nonreactive, whereas 44% of nonreactive tests failed to meet D awes-Redman criteria. Sensitivities, specificities, and positive and n egative predictive values were similar for both approaches. Additional tests or interventions would have occurred in 9% of the cases analyze d by System 8000 and in 49% of the cases analyzed visually. CONCLUSION S: Although these approaches rate nonstress tests differently, their d iagnostic performances are similar. Automated fetal heart rate testing may become an acceptable alternative to conventional visual analysis.