American Institute of Ultrasound in Medicine (AIUM) takes steps to improve the quality of ultrasound imaging in obstetrics and gynecology

AIUM’s findings and recommendations published simultaneously in the American Journal of Obstetrics & Gynecology, Journal of Ultrasound in Medicine, and Ultrasound in Obstetrics & Gynecology


Philadelphia, PA, and Hoboken, NJ, January 3, 2018

While ultrasound imaging is a commonly used diagnostic tool in obstetrics and gynecology, evidence suggests that the quality of ultrasound examination in clinical practice and ultrasound training in obstetrics and gynecology and radiology residency programs can be improved. To address these issues, the American Institute of Ultrasound in Medicine (AIUM) convened a forum tasked with developing a roadmap for quality improvement in ultrasound imaging in obstetrics and gynecology and set up a task force to establish a consensus curriculum and competency assessment tools for residency training. The results of these efforts are published simultaneously today in the American Journal of Obstetrics & Gynecology, Journal of Ultrasound in Medicine, and Ultrasound in Obstetrics & Gynecology.

In an effort to develop better standards, the forum, Beyond Ultrasound First, under the leadership of Beryl R. Benacerraf, MD, from Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, brought together representatives from many professional associations; the imaging community including radiology, obstetrics and gynecology, and emergency medicine among others; and government agencies, insurers, industry, and others with common interest in obstetric and gynecologic ultrasound. The aim of this forum, funded by AIUM's Endowment for Education and Research, was to increase and unify the quality of ultrasound examinations in obstetrics and gynecology with the ultimate goal of improving patient safety and quality of clinical care.

“Improving the quality of ultrasound examinations will have a substantial impact on patient care and healthcare costs,” explained Dr. Benacerraf. “Furthermore, standardizing the approach to ultrasound training in residency programs and providing tools to measure competency in a comprehensive way is a novel approach that will ensure training and thus impact long term patient care. To our knowledge, this is the first time that a multi-society curriculum and competency assessment tools have been created for residency training in clinical imaging.”

Roberto Romero, MD, DMedSci., Editor-in-Chief for Obstetrics of the American Journal of Obstetrics & Gynecology, stated that "a curriculum in ultrasound for training future physicians in obstetrics and gynecology and related disciplines was necessary to improve the care of women and their unborn children. We are pleased to make available to the entire world the recommendations of the Task Force as well as the images and criteria for evaluation to strengthen education, enhance training, and promote high-quality medical practice."

While most obstetricians and gynecologists agree that ultrasound should be the first-choice imaging method, its use and level of competency with which it is performed are variable. The proceedings of this conference focus on the key issues identified and possible approaches to resident teaching and means to improve the inconsistent quality of ultrasound examinations performed today:

  • Understanding the role of ultrasound in clinical imaging and the importance of complying with ultrasound first when feasible
  • Ensuring that ultrasound is performed in high quality in order to minimize false positive and false negative findings
  • Incorporating the curriculum and competency assessment tools in residency programs to ensure standardization of training
  • Gaining insights into the payer’s perspectives

According to Dr. Benacerraf, “Ultrasound can be immensely informative, but it requires more skill and training than just pushing a button. Those that make the effort to master the modality will reap rich rewards for their patients, trainees, and themselves and often avoid moving on to other imaging studies by providing the diagnosis with sonography. The practice of ultrasound offers the imager the possibility of direct patient contact to guide the exam, which is unique to ultrasound and represents the essence of our profession.”

The multi-society task force that developed the curriculum to standardize teaching of ultrasound in OB GYN for Residents was led by Alfred Z. Abuhamad, MD, of Eastern Virginia Medical School, Norfolk, VA. Their efforts resulted in a consensus report that describes essential topics in medical ultrasound training, a level-based framework to guide trainees to increasing competence, and a competency assessment that involves evaluation of still ultrasound images, movie clips, realtime scanning, or a combination of methods, that can be implemented by individual programs.

“This consensus-based curriculum and competency assessment will provide the tools to ensure standardization of ultrasound training in residency programs. Ensuring optimal training of ultrasound in residency programs will result in improved quality of ultrasound examinations in clinical practice,” commented Dr. Abuhamad.

Biparietal diameter along with the list of criteria for competency. A teaching example from the curriculum that describes how an important measurement of a developing fetus is made.

Basky Thilaganathan, MD, PhD, FRCOG, St George's, University of London, Cardiovascular Sciences Research Centre, London, UK, and Editor-in-Chief, Ultrasound in Obstetrics & Gynecology (UOG) added, “Ultrasound imaging is now established in the practice of obstetrics and gynecology, making systematic education and assessment in this competency a necessity, rather than optional. UOG is pleased to publish the framework for curriculum based training to allow structured practical training and experience in this specialty.”

Ultrasound imaging is dependent on the operator to a much greater extent than computed tomography (CT) or magnetic resonance imaging (MRI). Obstetric ultrasound imaging is particularly challenging, given the small size of fetal organs and the variable fetal position in the uterus. This makes training and competency assessment an important factor in the quality of the ultrasound examination.

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Notes for Editors
The articles are:

“Proceedings: Beyond Ultrasound First Forum on improving the quality of ultrasound imaging in obstetrics and gynecology,” by Beryl R. Benacerraf, MD; Katherine K. Minton, MA, RDMS, RDCS; Carol B. Benson, MD; Bryann S. Bromley, MD; Brian D. Coley, MD; Peter M. Doubilet, MD, PhD; Wesley Lee, MD; Samuel H. Maslak, DSc; John S. Pellerito, MD; James J. Perez, DO; Eric Savitsky, MD; Norman A. Scarborough, MD, DABR; Joseph Wax, MD; Alfred Z. Abuhamad, MD. Co-published in the American Journal of Obstetrics & Gynecology, volume 218, issue 1 (January 2018), https://doi.org/10.1016/j.ajog.2017.06.033, published by Elsevier, and the Journal of Ultrasound in Medicine, volume 37, issue 1 (January 2018), http://onlinelibrary.wiley.com/doi/10.1002/jum.14504/full , published by Wiley.

“Obstetric and Gynecologic Ultrasound Curriculum and Competency Assessment in Residency Training Programs: Consensus Report,” by Alfred Abuhamad, MD; Katherine K. Minton, MA, RDMS, RDCS; Carol B. Benson; Trish Chudleigh, PhD; Lori Crites, BS, RDMS; Peter M. Doubilet, MD, PhD; Rita Driggers, MD; Wesley Lee, MD; Karen V. Mann, MD; James J. Perez, DO; Nancy C. Rose, MD; Lynn L. Simpson, MD; Ann Tabor, MD; and Beryl R. Benacerraf, MD. Co-published in the American Journal of Obstetrics & Gynecology, volume 218, issue 1 (January 2018), https://doi.org/10.1016/j.ajog.2017.10.016, published by Elsevier, the Journal of Ultrasound in Medicine, volume 37, issue 1 (January 2018), http://onlinelibrary.wiley.com/doi/10.1002/jum.14519/full , and Ultrasound in Obstetrics & Gynecology, volume 51, issue 1 (January 2018), http://onlinelibrary.wiley.com/doi/10.1002/uog.18967/full, published by Wiley.

Both articles are openly available in all journals. In addition, credentialed journalists may request full text. Contact Eileen Leahy at +1 732-238-3628; ajogmedia@elsevier.com or Penny Smith at +44 (0) 1243 770448; sciencenewsroom@wiley.com to obtain copies. Beryl R. Benacerraf, MD, may be reached for comment at +1 617-739-0245 or berylbenacerraf@post.harvard.edu. Journalists may reach Alfred Abuhamad, MD, at +1 757-446-5283 or abuhamaz@evms.edu.

About the American Journal of Obstetrics & Gynecology
The American Journal of Obstetrics & Gynecology, known as “The Gray Journal,” presents coverage of the entire spectrum of the field, from the newest diagnostic procedures to leading edge research. The Journal provides comprehensive coverage of the specialty, including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. It also publishes the annual meeting papers of several of its eight sponsoring societies, including the Society for Maternal-Fetal Medicine and the Society of Gynecologic Surgeons. www.AJOG.org

About the Journal of Ultrasound in Medicine
The Journal of Ultrasound in Medicine is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1550-9613

About Ultrasound in Obstetrics & Gynecology
The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), Ultrasound in Obstetrics & Gynecology (UOG) is an international, peer-reviewed journal publishing articles focused on, but not limited to, Maternal Fetal Medicine, Gynecology, and Ultrasound Techniques. Published monthly, UOG is read by Obstetricians, Gynecologists, Radiologists, Pediatricians, Sonographers, Midwives and Radiographers. http://obgyn.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)1469-0705

About the American Institute of Ultrasound in Medicine (AIUM)
The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary medical association of more than 10,000 physicians, sonographers, scientists, students, and other health care providers. It is dedicated to advancing the safe and effective use of ultrasound in medicine. For more information visit www.aium.org.

About Wiley
Wiley, a global research and learning company, helps people and organizations develop the skills and knowledge they need to succeed. Our online scientific, technical, medical, and scholarly journals, combined with our digital learning, assessment and certification solutions help universities, learned societies, businesses, governments and individuals increase the academic and professional impact of their work. For more than 210 years, we have delivered consistent performance to our stakeholders. www.wiley.com

About Elsevier
Elsevier is a global information analytics business that helps institutions and professionals advance healthcare, open science and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support and professional education, including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 38,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com

Media contacts:
Eileen Leahy
Elsevier
+1 732-238-3628
ajogmedia@elsevier.com

Penny Smith
Wiley
+44 (0) 1243 770448
sciencenewsroom@wiley.com