How accurate are ultra-sound scan results
When a 22-year-old seam-stress, Mrs Toyin Ijalola, was, told by her obstetrician, in her second trimester to go for scanning,
•Experts meet to address challenges
When a 22-year-old seam-stress, Mrs Toyin Ijalola, was, told by her obstetrician, in her second trimester to go for scanning, she did without reservation. When the result was out, she was told hers is a multiple pregnancy and the babies are doing fine. Images were printed and she took same to her doctor.
Her doctor was not convinced. He ordered another scan and the result showed she has singleton and the other mass was uterine fibroid.
Another patient, 32-year-old Jaiyeoba Iginla, was told she has fibroid and the image printed indicated same. Yet, the result did not detail the size and the position of the fibroid. She decided to access another facility, though she paid a higher fee. The result confirmed a mass growth, called fibroid but the fibroid was insignificant.
These are the experiences of some patients when they visit ultra-sound scan centres. But to experts such results are not unexpected and some of them are making efforts to correct the anomaly. One of them is the Medical Director, Nordica Fertility Centre, Dr Abayomi Ajayi.
Many practitioners have obsolete ultrasound scan machines, a problem which hampers the utilisation of the full benefits of the ultra-sound scanning procedures. Many of the scanners in the country are too old to be accurate, while lack of proper training limits the interpretation competence of the physician. "Training is first and foremost the biggest challenge, which is why we have brought professionals from the United Kingdom and United States to complement our local skills. Emphasis has been on training the doctors themselves. It is essential the operator must know what he is doing.
"We have found ultrasound machines being handled by untrained people turn out reports that are of no benefit to the physician. So, first thing we are doing is to train the physician and let him know his limitations," he said.
He spoke during the sixth edition of the Ultrasound Scan Training Workshop organised by Nordica Fertility Centre.
A facilitator at the event, the Quality Co-ordinator, Pacific Medical Centre, Seattle, US, Dr. Christopher Ashton, said one of the aims of the workshop was to enable participants to gain more confidence as part of the heightened skill levels and basic background information they would derive on all aspects of imaging and diagnostic procedures. "We are enabling them to know how to use the machines, how to position the patients and how to interpret the results properly."
Ashton who described lack of training as the biggest barrier in Nigeria, noted that with the right skill, the correct ultrasound information could always be sought and made available.
"In Nigeria there is no basic infrastructure in the healthcare system for ultrasound training. There is no internship programme in ultrasound, and it takes a long time to get the required skill set, unlike in the US where it takes about a year to get well-trained sonographers to operate on their own. No matter how little it is, training matter a lot because it will go a long way to assist your medical profession.
"We have a radiologist to back us up, but here in Nigeria, there does not seem to be the right support system. There is the need to develop the support systems between the physician and the hospital. This is why we encourage the participants on the need to communicate with each other as they continue to grow and share information."
Another resource person, the Medical Direct0or, Crestview Limited, Dr Abiodun Fashade, said to get it right from the word go, and hopefully have a multiplier effect, the crop of the doctors in training are from public hospitals, especially the tertiary institutions. "You discover that the expertise on the training we’ve been having here are from training institutions. The field of Sonography is more operators dependent. It is very important that the operator knows what he is doing and if he does not know they there is a problem.
"And you will discover that what we are also trying to do is for the operators to know their limitations. This is because I know in this environment, the greatest challenge that we have found is that, the machine are in the hands of people who are not trained and what do they do? They keep turning out reports that do not help the physician, the patients or the hospital research."
Dr Ajayi said: "The first thing that we do is to train the physicians to let them know what to do and know their limitations. Another is to know what to look for, and you will be sure when you don’t have it, you will know, and if you know what you are looking for, and your equipment is not giving you what you are looking for, of course you will know. It could be you are not using probably the appropriate machine for that thing.
"Unfortunately, another problem we are having is that there are infiltrations of substandard machines, that is, obsolete equipment in the market, but then if the practitioner or the technician is well educated, he will know how to get the best for his work.
"Our plan is to train 50 people who can train others. After a while, we will form a critical mark which cannot be ignored. It might be slow doing it, especially getting people who have done it in other countries to be involved in this type of thing. We are interested in making sure we have an impact. After training the doctors, the other people we also have to consider are the nurses, whether we like it or not, they are useful in the health of Nigerians. It is better to empower them so that they will impact it as well on the health of people.
"After training the doctor, the other people we also have to consider are the nurses, whether we like it or not, they are useful in the health of Nigeria. It is better to enable them so that they will impart it as well on health of people."