Verification of an online evaluation system

Las conferencias impartidas por especialistas promueven el interés de los alumnos por la materia en la que se realizan. Para mejorar el aprendizaje, pusimos a disposición de los alumnos en la plataforma WebCT conferencias online de especialistas a quienes los estudiantes pudieron consultar dudas a través de un foro. Las conferencias se elaboraron 2 medianteWimbaClassroom. La realización de exámenes online permitió comprobar el grado de comprensión de las mismas. Para analizar el nivel de aprendizaje alcanzado mediante dichos exámenes, se incluyeron preguntas sobre las charlas en el examen escrito de la asignatura. La calificación de los alumnos que realizaron la actividad fue un 33% superior que la de quienes no la realizaron, existiendo una correlación directa entre la calificación obtenida online y la del examen escrito. Más del 75% consideróesta herramienta de aprendizaje positiva y el 90 % considera que la experiencia debe extenderse a otras asignaturas

Inter-laboratory agreement on embryo classification and clinical decision: Conventional morphological assessment vs. time lapse

<div><p>The aim of this study is to determine inter-laboratory variability on embryo assessment using time-lapse platform and conventional morphological assessment. This study compares the data obtained from a pilot study of external quality control (EQC) of time lapse, performed in 2014, with the classical EQC of the Spanish Society for the Study of Reproductive Biology (ASEBIR) performed in 2013 and 2014. In total, 24 laboratories (8 using EmbryoScope™, 15 using Primo Vision™ and one with both platforms) took part in the pilot study. The clinics that used EmbryoScope™ analysed 31 embryos and those using Primo Vision™ analysed 35. The classical EQC was implemented by 39 clinics, based on an analysis of 25 embryos per year. Both groups were required to evaluate various qualitative morphological variables (cell fragmentation, the presence of vacuoles, blastomere asymmetry and multinucleation), to classify the embryos in accordance with ASEBIR criteria and to stipulate the clinical decision taken. In the EQC time-lapse pilot study, the groups were asked to determine, as well as the above characteristics, the embryo development times, the number, opposition and size of pronuclei, the direct division of 1 into 3 cells and/or of 3 into 5 cells and false divisions. The degree of agreement was determined by calculating the intra-class correlation coefficients and the coefficient of variation for the quantitative variables and the Gwet index for the qualitative variables. For both EmbryoScope™ and Primo Vision™, two periods of greater inter-laboratory variability were observed in the times of embryo development events. One peak of variability was recorded among the laboratories addressing the first embryo events (extrusion of the second polar body and the appearance of pronuclei); the second peak took place between the times corresponding to the 8-cell and morula stages. In most of the qualitative variables analysed regarding embryo development, there was almost-perfect inter-laboratory agreement among conventional morphological assessment (CMA), EmbryoScope™ and Primo Vision™, except for false divisions, vacuoles and asymmetry (users of all methods) and multinucleation (users of Primo Vision™), where the degree of agreement was lower. The inter-laboratory agreement on embryo classification according to the ASEBIR criteria was moderate-substantial (Gwet 0.41–0.80) for the laboratories using CMA and EmbryoScope™, and fair-moderate (Gwet 0.21–0.60) for those using Primo Vision™. The inter-laboratory agreement for clinical decision was moderate (Gwet 0.41–0.60) on day 5 for CMA users and almost perfect (Gwet 0.81–1) for time-lapse users. In conclusion, time-lapse technology does not improve inter-laboratory agreement on embryo classification or the analysis of each morphological variable. Moreover, depending on the time-lapse platform used, inter-laboratory agreement may be lower than that obtained by CMA. However, inter-laboratory agreement on clinical decisions is improved with the use of time lapse, regardless of the platform used.</p></div

ICC and 95% CIs (error bars) obtained at different times of embryo development, for both morphokinetic platforms.

<p>ICC and 95% CIs (error bars) obtained at different times of embryo development, for both morphokinetic platforms.</p

Degree of inter-laboratory agreement (Gwet AC2 index) on the evaluation of embryo variables, by TL and CMA.

<p>Degree of inter-laboratory agreement (Gwet AC2 index) on the evaluation of embryo variables, by TL and CMA.</p

Mean times of the quantitative variables for both morphokinetic platforms (maximum and minimum).

<p>Mean times of the quantitative variables for both morphokinetic platforms (maximum and minimum).</p

Percentage of embryos with a high degree of agreement on embryo classification according to ASEBIR criteria.

<p>Percentage of embryos with a high degree of agreement on embryo classification according to ASEBIR criteria.</p

Mean CV and 95% CIs (error bars) obtained at different times of embryo development for both morphokinetic platforms.

<p>Mean CV and 95% CIs (error bars) obtained at different times of embryo development for both morphokinetic platforms.</p

Percentage of embryos with a high degree of agreement on clinical decision.

<p>Percentage of embryos with a high degree of agreement on clinical decision.</p

Inter-laboratory agreement on embryo classification and clinical decision: Conventional morphological assessment vs. time lapse.

The aim of this study is to determine inter-laboratory variability on embryo assessment using time-lapse platform and conventional morphological assessment. This study compares the data obtained from a pilot study of external quality control (EQC) of time lapse, performed in 2014, with the classical EQC of the Spanish Society for the Study of Reproductive Biology (ASEBIR) performed in 2013 and 2014. In total, 24 laboratories (8 using EmbryoScope™, 15 using Primo Vision™ and one with both platforms) took part in the pilot study. The clinics that used EmbryoScope™ analysed 31 embryos and those using Primo Vision™ analysed 35. The classical EQC was implemented by 39 clinics, based on an analysis of 25 embryos per year. Both groups were required to evaluate various qualitative morphological variables (cell fragmentation, the presence of vacuoles, blastomere asymmetry and multinucleation), to classify the embryos in accordance with ASEBIR criteria and to stipulate the clinical decision taken. In the EQC time-lapse pilot study, the groups were asked to determine, as well as the above characteristics, the embryo development times, the number, opposition and size of pronuclei, the direct division of 1 into 3 cells and/or of 3 into 5 cells and false divisions. The degree of agreement was determined by calculating the intra-class correlation coefficients and the coefficient of variation for the quantitative variables and the Gwet index for the qualitative variables. For both EmbryoScope™ and Primo Vision™, two periods of greater inter-laboratory variability were observed in the times of embryo development events. One peak of variability was recorded among the laboratories addressing the first embryo events (extrusion of the second polar body and the appearance of pronuclei); the second peak took place between the times corresponding to the 8-cell and morula stages. In most of the qualitative variables analysed regarding embryo development, there was almost-perfect inter-laboratory agreement among conventional morphological assessment (CMA), EmbryoScope™ and Primo Vision™, except for false divisions, vacuoles and asymmetry (users of all methods) and multinucleation (users of Primo Vision™), where the degree of agreement was lower. The inter-laboratory agreement on embryo classification according to the ASEBIR criteria was moderate-substantial (Gwet 0.41-0.80) for the laboratories using CMA and EmbryoScope™, and fair-moderate (Gwet 0.21-0.60) for those using Primo Vision™. The inter-laboratory agreement for clinical decision was moderate (Gwet 0.41-0.60) on day 5 for CMA users and almost perfect (Gwet 0.81-1) for time-lapse users. In conclusion, time-lapse technology does not improve inter-laboratory agreement on embryo classification or the analysis of each morphological variable. Moreover, depending on the time-lapse platform used, inter-laboratory agreement may be lower than that obtained by CMA. However, inter-laboratory agreement on clinical decisions is improved with the use of time lapse, regardless of the platform used