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The reproductibility of the results of transvaginal sonography of the uterus in patients with abnormal uterine bleeding
Author(s) -
Emanuel M. H.,
Ankum W. M.,
Verdel M. J. C.,
Hart A. A. M.
Publication year - 1996
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.1996.08050346.x
Subject(s) - medicine , uterus , mcnemar's test , uterine cavity , kappa , myometrium , gynecology , endometrium , uterine bleeding , reproducibility , radiology , obstetrics , linguistics , statistics , philosophy , mathematics
Our objectives were to determine the reproducibility, or interobserver agreement, of transvaginal sonographic imaging of the uterus in patients with abnormal uterine bleeding and to identify the effect of observer experience. Transvaginal ultrasound findings of 235 patients with abnormal uterine bleeding were recorded systematically on videotape. Recordings were reviewed by three observers who had different levels of experience, and who were asked to judge the endometrium/uterine cavity and myometrium separately as being normal, abnormal or inconclusive, according to predefined criteria. Reproducibility was expressed by the observed rates of interobserver agreement and by kappa statistics. The differences in agreement between observer pairs were analyzed by means of McNemar's χ2 test. The observed rates of agreement for the judgement of the endometrium/uterine cavity varied from 0.85 to 0.89, with a kappa value ranging from 0.70 to 0.78 between observers. The judgement of the myometrium resulted in agreement rates of 0.86–0.91 and kappa values of 0.67–0.80. Although the effect of experience was evident, the differences in agreement between observers were not significant ( p > 0.01). The reproducibility of the results of transvaginal sonography of the uterus in patients with abnormal uterine bleeding was good. Observations of the endometrium/uterine cavity with a normal appearance were the most highly reproducible, with the smallest effect of observer experience. This may reduce the need for invasive diagnostic procedures in patients with abnormal uterine bleeding. Copyright © 1996 International Society of Ultrasound in Obstetrics and Gynecology