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A survey of obstetric ultrasound uses and priorities for artificial intelligence-assisted obstetric ultrasound in low- and middle-income countries


A complete of 176 respondents participated in this on-line survey, representing 34 countries (Fig. 1), with 96% from LMIC, together with 63% from Africa and 32% from Asia (Desk 1). The imply age of respondents reporting their age was 41 (vary 20 to 74) years and 64% of respondents reporting their intercourse have been feminine. Of these reporting their highest stage of schooling/coaching, 41% recognized as physicians, 49% as nurses or midwives, and 6% as ultrasound/radiology technicians.

Fig. 1
figure 1

Survey respondents by nation. Map created utilizing ArcMap 10.7.1 (ESRI 2019. ArcGIS Desktop: Launch 10.7.1. Redlands, CA: Environmental Techniques Analysis Institute).

Desk 1 Survey respondents.

Amongst respondents describing their healthcare facility, 61% labored in hospitals, with 69% at a tertiary or tutorial hospital, and 28% supplied care in well being facilities (Desk 2). Extra respondents labored in healthcare services situated in city settings (51%), than in rural (36%) or peri-urban (16%) settings. Extra respondents labored in publicly funded (77%) than privately funded (31%) healthcare services. Entry to ultrasound in their present medical setting(s) was reported by 85% respondents and 11% reported no entry to ultrasound. Moveable ultrasounds (of which 56% have been handheld) have been utilized by 33%, non-portable ultrasounds by 32%, and 35% used each. Probes used included curved (68%), linear (44%), endocavitary (35%), and multi-use (24%). Regarding storage, 45% reported the flexibility to retailer OBUS photographs, with 44% storing on private units corresponding to computer systems, tablets, telephones and/or exterior exhausting drives, 40% on image archiving and communication techniques, and 22% in digital well being document techniques. Of notice, solely 52% reported their place of work had insurance policies and/or pointers for OBUS use.

Desk 2 Healthcare facility and ultrasound tools.

Of the 72% who obtained OBUS schooling and/or coaching, 56% reported additionally coaching others; 28% of respondents reported receiving no OBUS schooling and/or coaching (Supplementary Desk S1). Upon asking respondents to price their OBUS experience, 60% thought of themselves very or considerably skilled, 20% reported being inexperienced or considerably inexperienced, and 20% reported no expertise. When requested about frequency of OBUS use, 58% reported day by day use, 15% weekly, 6% month-to-month or each few months, and 16% hardly ever or by no means. Concerning confidence in their means to make use of OBUS in medical care, 77% felt considerably assured, assured, or very assured in their means to make use of OBUS.

Concerning what they used OBUS for in their medical setting, when introduced with 23 choices (together with the flexibility so as to add different ones), probably the most generally chosen included evaluation of gestational age (92%), fetal viability (92%), fetal presentation (92%), a number of gestation (86%), amniotic fluid quantity (84%), ectopic being pregnant (81%), placenta previa or different placental anomaly (79%), and molar being pregnant (76%) (Fig. 2, Supplementary Desk S2). When requested to establish solely the 5 highest-priority OBUS uses in their settings, probably the most generally chosen have been gestational age (79%), fetal viability (69%), ectopic being pregnant (50%), and fetal presentation (50%) (Fig. 2, Supplementary Desk S2).

Fig. 2
figure 2

Obstetric ultrasound uses and priorities.

Contemplating OBUS use by respondent’s highest schooling/coaching, over 90% of physicians and ultrasound technicians used OBUS to evaluate gestational age, fetal viability, ectopic being pregnant, fetal presentation, amniotic fluid quantity, and placental previa or different placental anomaly (Desk 3). Moreover, maternal-fetal medication (MFM) specialists and ultrasound technicians utilized OBUS extra incessantly to evaluate fetal anomalies and development restriction (Supplementary Determine S1). MFM specialists (77%) used OBUS for procedures greater than basic obstetricians (52%), different physicians (36%), and nurses and midwives (13%). Though nurses and midwives made up the biggest schooling/coaching group of respondents in our survey, in contrast with physicians, a considerably decrease proportion of nurses and midwives utilized OBUS for all use circumstances besides for termination of being pregnant.

Desk 3 Obstetric ultrasound uses by respondent schooling/coaching.

Upon contemplating highest-priority OBUS uses by respondent’s highest schooling/coaching, evaluation of gestational age was the one use chosen by a majority (> 50%) of respondents throughout all schooling/coaching teams (Desk 4). Along with evaluation of gestational age, MFM specialists additionally recognized evaluation of a number of gestation (69%), fetal anomalies (62%), ectopic being pregnant (54%), and fetal development restriction (54%) as the very best OBUS priorities whereas basic obstetricians additionally recognized evaluation of fetal viability (67%) and ectopic being pregnant (54%), different physicians additionally selected evaluation of fetal viability (69%), and vaginal bleeding (54%), and nurses and midwives additionally chosen evaluation of fetal viability (72%), fetal presentation (65%), and a number of gestation (56%) as the very best OBUS priorities (Supplementary Determine S2). Each the commonest and the highest-priority OBUS uses have been related when evaluating the respondents from Africa vs. Asia vs. Different (Supplementary Desk S3).

Desk 4 Obstetric ultrasound use priorities by respondent schooling/coaching.

The bulk of respondents famous that entry to ultrasound was crucial (80%) or vital (4%), with the rest (16%) believing entry was very unimportant (Desk 5). Amongst respondents, the good majority both strongly agreed or agreed that OBUS improves high quality of care (98%) and affected person outcomes (97%). When requested in regards to the potential usefulness of AI-assisted OBUS in the care of pregnant sufferers, 53% believed it might be at all times or incessantly helpful, 38% typically helpful, and 9% occasionally or by no means helpful. When queried about any fears or reservations related to utilizing AI-assisted OBUS in a medical setting, two-thirds mentioned they’d none. Of these expressing fears or reservations, healthcare suppliers not understanding the expertise (71%), misdiagnosis (62%), price (59%), sufferers not understanding the expertise (47%), malpractice (43%), and misuse (43%) have been the commonest.

Desk 5 Perceptions of obstetric ultrasound use and artificial intelligence help.



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