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Interobserver agreement and accuracy of non-invasive diagnosis of endometriosis by transvaginal sonography.
Ultrasound Obstet Gynecol 2015; 46(6):737-40UO

Abstract

OBJECTIVES

To evaluate interobserver agreement and accuracy of transvaginal sonography (TVS) in diagnosing deep infiltrating endometriosis (DIE) and endometriomas.

METHODS

A total of 67 consecutive patients referred to a pelvic pain clinic and scheduled for laparoscopy were enrolled in the study between January 2013 and January 2014. Patients were independently examined prospectively by two experienced sonographers (Observers A and B) who were blinded to the other's results. For the two observers, Gwet's first-order agreement coefficient (Gwet's AC1) was used to calculate interobserver agreement and diagnostic accuracy, as well as sensitivity, specificity, positive (PPV) and negative (NPV) predictive values using TVS, as compared to laparoscopy, for diagnosing DIE and endometriomas.

RESULTS

Among the 67 patients enrolled, 65 were analyzed. For the diagnosis of DIE and endometriomas by TVS, the level of agreement (Gwet's AC1) between Observers A and B and sensitivity/specificity values for the respective Observers were, by site: vagina (Gwet's AC1, 0.933; 62%/94% and 82%/94%), bladder (Gwet's AC1, 1.00; 67%/97% and 67%/97%), uterosacral ligaments (Gwet's AC1, 0.84; 73%/83% and 53%/90%), adnexa (Gwet's AC1, 0.95; 71%/93% and 71%/93%), rectovaginal septum (Gwet's AC1, 0.95; 40%/90% and 33%/87%) and rectosigmoid (Gwet's AC1, 0.98; 93%/96% and 94%/98%) which reflected high interobserver agreement. With the exception of sensitivity of diagnosis of DIE affecting the RVS, similar results were observed when TVS was compared with laparoscopy.

CONCLUSIONS

TVS is a highly accurate and reproducible method for non-invasive diagnosis of DIE by well-trained professionals.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Level III Center for Endometriosis and Pelvic Pain, Wilhelminen Hospital, Vienna, Austria.Department of Obstetrics and Gynaecology, Level III Center for Endometriosis and Pelvic Pain, Wilhelminen Hospital, Vienna, Austria.Department of Obstetrics and Gynaecology, Level III Center for Endometriosis and Pelvic Pain, Wilhelminen Hospital, Vienna, Austria.Department of Obstetrics and Gynaecology, Level III Center for Endometriosis and Pelvic Pain, Wilhelminen Hospital, Vienna, Austria.Department of Obstetrics and Gynaecology, Level III Center for Endometriosis and Pelvic Pain, Wilhelminen Hospital, Vienna, Austria.Department of Thoracic Surgery, Otto Wagner Hospital, Vienna, Austria.Department of Obstetrics and Gynaecology, Level III Center for Endometriosis and Pelvic Pain, Wilhelminen Hospital, Vienna, Austria. Stiftung Endometrioseforschung, Westerstede, Germany.

Pub Type(s)

Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25766661

Citation

Tammaa, A, et al. "Interobserver Agreement and Accuracy of Non-invasive Diagnosis of Endometriosis By Transvaginal Sonography." Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 46, no. 6, 2015, pp. 737-40.
Tammaa A, Fritzer N, Lozano P, et al. Interobserver agreement and accuracy of non-invasive diagnosis of endometriosis by transvaginal sonography. Ultrasound Obstet Gynecol. 2015;46(6):737-40.
Tammaa, A., Fritzer, N., Lozano, P., Krell, A., Salzer, H., Salama, M., & Hudelist, G. (2015). Interobserver agreement and accuracy of non-invasive diagnosis of endometriosis by transvaginal sonography. Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 46(6), pp. 737-40. doi:10.1002/uog.14843.
Tammaa A, et al. Interobserver Agreement and Accuracy of Non-invasive Diagnosis of Endometriosis By Transvaginal Sonography. Ultrasound Obstet Gynecol. 2015;46(6):737-40. PubMed PMID: 25766661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interobserver agreement and accuracy of non-invasive diagnosis of endometriosis by transvaginal sonography. AU - Tammaa,A, AU - Fritzer,N, AU - Lozano,P, AU - Krell,A, AU - Salzer,H, AU - Salama,M, AU - Hudelist,G, PY - 2014/08/26/received PY - 2015/03/02/revised PY - 2015/03/07/accepted PY - 2015/3/14/entrez PY - 2015/3/15/pubmed PY - 2016/9/13/medline KW - diagnostic accuracy KW - endometriosis KW - interobserver variability KW - transvaginal sonography KW - ultrasound SP - 737 EP - 40 JF - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JO - Ultrasound Obstet Gynecol VL - 46 IS - 6 N2 - OBJECTIVES: To evaluate interobserver agreement and accuracy of transvaginal sonography (TVS) in diagnosing deep infiltrating endometriosis (DIE) and endometriomas. METHODS: A total of 67 consecutive patients referred to a pelvic pain clinic and scheduled for laparoscopy were enrolled in the study between January 2013 and January 2014. Patients were independently examined prospectively by two experienced sonographers (Observers A and B) who were blinded to the other's results. For the two observers, Gwet's first-order agreement coefficient (Gwet's AC1) was used to calculate interobserver agreement and diagnostic accuracy, as well as sensitivity, specificity, positive (PPV) and negative (NPV) predictive values using TVS, as compared to laparoscopy, for diagnosing DIE and endometriomas. RESULTS: Among the 67 patients enrolled, 65 were analyzed. For the diagnosis of DIE and endometriomas by TVS, the level of agreement (Gwet's AC1) between Observers A and B and sensitivity/specificity values for the respective Observers were, by site: vagina (Gwet's AC1, 0.933; 62%/94% and 82%/94%), bladder (Gwet's AC1, 1.00; 67%/97% and 67%/97%), uterosacral ligaments (Gwet's AC1, 0.84; 73%/83% and 53%/90%), adnexa (Gwet's AC1, 0.95; 71%/93% and 71%/93%), rectovaginal septum (Gwet's AC1, 0.95; 40%/90% and 33%/87%) and rectosigmoid (Gwet's AC1, 0.98; 93%/96% and 94%/98%) which reflected high interobserver agreement. With the exception of sensitivity of diagnosis of DIE affecting the RVS, similar results were observed when TVS was compared with laparoscopy. CONCLUSIONS: TVS is a highly accurate and reproducible method for non-invasive diagnosis of DIE by well-trained professionals. SN - 1469-0705 UR - https://www.unboundmedicine.com/medline/citation/25766661/Interobserver_agreement_and_accuracy_of_non_invasive_diagnosis_of_endometriosis_by_transvaginal_sonography_ L2 - https://doi.org/10.1002/uog.14843 DB - PRIME DP - Unbound Medicine ER -