Formative Assessment Based on an Audit and Feedback Improves Nuchal Translucency Ultrasound Image Quality

ith increasing demands being placed on limited health care resources, screening procedures must be not only clinically efficient but also cost-effective.1 Physicians performing prenatal ultrasound examinations are thus encouraged to take part in quality control initiatives. An audit is one method of assessing clinical performance over time and may be followed by practice recommendations.2 A meta-analysis of 118 studies by Jamtvedt et al3 concluded that an audit can moderately improve professional health care practice. First-trimester measurement of nuchal translucency and crown-rump length is a screening method for possible chromosomal abnormalities,4 identifying a group of high-risk patients qualifying for invasive diagnostic testing.5 Because invasive tests carry a risk of Gihad E. Chalouhi, MD, Laurent J. Salomon, MD, PhD, Marianne Fontanges, MD, Marc Althuser, MD, Georges Haddad, MD, Olivier Scemama, MD, Jean-Michel Chabot, MD, Michel Duyme, MD, Nicolas Fries, MD