Dataset Information

Endometriosis diagnosis and staging by operating surgeon and expert review using multiple diagnostic tools: an inter-rater agreement study.

ABSTRACT:

Objective

To determine agreement on endometriosis diagnosis between real-time laparoscopy and subsequent expert review of digital images, operative reports, magnetic resonance imaging (MRI), and histopathology, viewed sequentially.

Design

Inter-rater agreement study.

Setting

Five urban surgical centres.

Population

Women, aged 18-44 years, who underwent a laparoscopy regardless of clinical indication. A random sample of 105 women with and 43 women without a postoperative endometriosis diagnosis was obtained from the ENDO study.

Methods

Laparoscopies were diagnosed, digitally recorded, and reassessed.

Main outcome measures

Inter-observer agreement of endometriosis diagnosis and staging according to the revised American Society for Reproductive Medicine criteria. Prevalence and bias-adjusted kappa values (?) were calculated for diagnosis, and weighted ? values were calculated for staging.

Results

Surgeons and expert reviewers had substantial agreement on diagnosis and staging after viewing digital images (n = 148; mean ? = 0.67, range 0.61-0.69; mean ? = 0.64, range 0.53-0.78, respectively) and after additionally viewing operative reports (n = 148; mean ? = 0.88, range 0.85-0.89; mean ? = 0.85, range 0.84-0.86, respectively). Although additionally viewing MRI findings (n = 36) did not greatly impact agreement, agreement substantially decreased after viewing histological findings (n = 67), with expert reviewers changing their assessment from a positive to a negative diagnosis in up to 20% of cases.

Conclusion

Although these findings suggest that misclassification bias in the diagnosis or staging of endometriosis via visualised disease is minimal, they should alert gynaecologists who review operative images in order to make decisions on endometriosis treatment that operative reports/drawings and histopathology, but not necessarily MRI, will improve their ability to make sound judgments.

Tweetable abstract

Endometriosis diagnosis and staging agreement between expert reviewers and operating surgeons was substantial.

SUBMITTER: Schliep KC

PROVIDER: S-EPMC4821828 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Endometriosis diagnosis and staging by operating surgeon and expert review using multiple diagnostic tools: an inter-rater agreement study.

Schliep K C KC Chen Z Z Stanford J B JB Xie Y Y Mumford S L SL Hammoud A O AO Boiman Johnstone E E Dorais J K JK Varner M W MW Buck Louis G M GM Peterson C M CM

BJOG : an international journal of obstetrics and gynaecology 20151005 2

<h4>Objective</h4>To determine agreement on endometriosis diagnosis between real-time laparoscopy and subsequent expert review of digital images, operative reports, magnetic resonance imaging (MRI), and histopathology, viewed sequentially.<h4>Design</h4>Inter-rater agreement study.<h4>Setting</h4>Five urban surgical centres.<h4>Population</h4>Women, aged 18-44 years, who underwent a laparoscopy regardless of clinical indication. A random sample of 105 women with and 43 women without a postoperat ...[more]

PMID: 26435386

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Dataset Information

Endometriosis diagnosis and staging by operating surgeon and expert review using multiple diagnostic tools: an inter-rater agreement study.

Objective

Design

Setting

Population

Methods

Main outcome measures

Results

Conclusion

Tweetable abstract

Publications

Endometriosis diagnosis and staging by operating surgeon and expert review using multiple diagnostic tools: an inter-rater agreement study.

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