29 Observer agreement of aCTG assessments either primary care or hospital-based midwives. We did find a statistically significant difference in the proportion of agreement within the obstetricians versus residents (−0.12 [−0.03;–0.21], P-value 0.006). Table 2: Interobserver agreement in classification (reassuring and non-reassuring) of antenatal CTGs between (values off the diagonal) and within (values on the diagonal) professional groups using proportions of agreement Proportions of agreement (95% CI) Primary care midwives Hospital-based midwives Residents Obstetricians Primary care midwives 0.84 (0.72-0.91) 0.84 (0.73-0.90) 0.83 (0.73-0.90) 0.82 (0.71-0.90) Hospital-based midwives x 0.86 (0.75-0.92) 0.90 (0.81-0.95) 0.86 (0.75-0.93) Residents x x 0.94 (0.87-0.98) 0.87 (0.77-0.93) Obstetricians x x x 0.82 (0.67-0.91) CTG, cardiotocography; CI, confidence interval Table 3 describes the intraobserver agreement for the classification of aCTG patterns for the professional groups. The proportions of agreement were slightly higher for intraobserver than for interobserver agreement and varied from 0.86 (95% CI: 0.55– 0.97) to 0.94 (95% CI: 0.66–0.99) for aCTG classification for the various professional groups. We found no differences in proportions of intraobserver agreement between obstetricians and the other professional groups. Table 3 Intraobserver agreement in classification (reassuring and non-reassuring) of antenatal CTGs for professional groups in maternity care using proportions of agreement Proportions of agreement (95% CI) Primary care midwives Hospital-based midwives Residents Obstetricians 0.92 (0.62 -0.99) 0.94 (0.66 -0.99) 0.91 (0.63-0.98) 0.86 (0.55 -0.97) CTG, cardiotocography; CI, confidence interval We also investigated the inter- and intraobserver agreement on the different components (baseline heart frequency, variability, accelerations, decelerations, and contractions) of aCTG patterns between and within the four professional groups. These results are presented in Tables S1 and S2. For interobserver agreement, the proportions of agreement on the aCTG components varied from 0.64 (presence of contractions) to 0.98 (baseline heart frequency). Overall, the proportions of agreement for the various aCTG components between and within the professional 2
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