Multicentre validation of an intelligent system for managing labour

Fetal condition during labour is inferred from a continuous visual recording of the fetal heart rate and uterine contractions, called the cardiotocogram (CTG). Difficulties in CTG interpretation is a major problem that can lead to both unnecessary Caesarean sections and damage to the infant. Our group has developed an intelligent system which applies expert knowledge to support clinical decision making during labour The system was previously found to obtain a performance comparable to local experts in two internal evaluations. This study presents a validation of the system which compared its management with 17 experts from 16 leading centres within the U.K. in 50 cases selected from a database of 2400 high risk labours. This study found that the majority of experts agreed well and were largely consistent in their management of the cases. The system obtained a performance that was indistinguishable from the experts. Copyright (C) 1996 Elsevier Science Ltd