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Interpretation of biophysical profiles by nurses and physicians.

OBJECTIVE
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.