Top

Published in:

01-02-2018 | General Gynecology

Effect of clinical information and previous exam execution on observer agreement and reliability in the analysis of hysteroscopic video-recordings

Authors: Margarida Suzel Lopes Martinho, Cristina Maria Nogueira da Costa Santos, João Luís Mendonça Silva Carvalho, João Francisco Montenegro Andrade Lima Bernardes

Published in: Archives of Gynecology and Obstetrics | Issue 2/2018

Abstract

Introduction

Inter-observer agreement and reliability in hysteroscopic image assessment remain uncertain and the type of factors that may influence it has only been studied in relation to the experience of hysteroscopists. We aim to assess the effect of clinical information and previous exam execution on observer agreement and reliability in the analysis of hysteroscopic video-recordings.

Materials and methods

Ninety hysteroscopies were video-recorded and randomized into a group without (Group 1) and with clinical information (Group 2). The videos were independently analyzed by three hysteroscopists, regarding lesion location, dimension, and type, as well as decision to perform a biopsy. One of the hysteroscopists had executed all the exams before. Proportions of agreement (PA) and kappa statistics (κ) with 95% confidence intervals (95% CI) were used.

Results

In Group 2, there was a higher proportion of a normal diagnosis (p < 0.001) and a lower proportion of biopsies recommended (p = 0.027). Observer agreement and reliability were better in Group 2, with the PA and κ ranging, respectively, from 0.73 (95% CI 0.62, 0.83) and 0.44 (95% CI 0.26, 0.63), for image quality, to 0.94 (95% CI 0.88, 0.99) and 0.85 (95% CI 0.65, 0.95), for the decision to perform a biopsy. Execution of the exams before the analysis of the video-recordings did not significantly affect the results.

Conclusion

With clinical information, agreement and reliability in the overall analysis of hysteroscopic video-recordings may reach almost perfect results and this was not significantly affected by the execution of the exams before the analysis. However, there is still uncertainty in the analysis of specific endometrial cavity abnormalities.

Widrich T, Bradley LD, Mitchinson AR, Collins RL (1996) Comparison of saline infusion sonography with office hysteroscopy for the evaluation of the endometrium. Am J Obstet Gynecol 174:1327–1334CrossRefPubMed

Fabres C, Alam V, Balmaceda J, Zegers-Hochschild F, Mackenna A, Fernandez E (1998) Comparison of ultrasonography and hysteroscopy in the diagnosis of intrauterine lesions in infertile women. J Am Assoc Gynecol Laparosc 5:375–378CrossRefPubMed

Ceci O, Bettocchi S, Pellegrino A, Impedovo L, Di Venere R, Pansini N (2002) Comparison of hysteroscopic and hysterectomy findings for assessing the diagnostic accuracy of office hysteroscopy. Fertil Steril 78:628–631CrossRefPubMed

Dueholm M, Lundorf E, Olesen F (2002) Imaging techniques for evaluation of the uterine cavity and endometrium in premenopausal patients before minimally invasive surgery. Obstet Gynecol Surv 57:388–403CrossRefPubMed

Karageyim Karsidag AY, Buyukbayrak EE, Kars B, Unal O, Turan MC (2010) Transvaginal sonography, sonohysterography, and hysteroscopy for investigation of focal intrauterine lesions in women with recurrent postmenopausal bleeding after dilatation and curettage. Arch Gynecol Obstet 281:637–643CrossRefPubMed

Dueholm M (2002) Reproducibility of evaluation of the uterus by transvaginal sonography, hysterosonographic examination, hysteroscopy and magnetic resonance imaging. Hum Reprod 17:195–200CrossRefPubMed

Kasius JC, Broekmans FJM, Veersema S, Eijkemans MJC, Van Santbrink EJP, Devroey P et al (2011) Observer agreement in the evaluation of the uterine cavity by hysteroscopy prior to in vitro fertilization. Hum Reprod 26:801–807CrossRefPubMed

Smit JG, Overdijkink S, Mol BW, Kasius JC, Torrance HL, Eijkemans MJC et al (2015) The impact of diagnostic criteria on the reproducibility of the hysteroscopic diagnosis of the septate uterus: a randomized controlled trial. Hum Reprod 30(6):1323–1330CrossRefPubMed

Dueholm M, Hjorth IMD, Secher P, Jørgensen A, Ørtoft G (2015) Reproducibility of endometrial pathologic findings obtained on hysteroscopy, transvaginal sonography, and gel infusion sonography in women with postmenopausal bleeding. J Minim Invasive Gynecol 22:1036–1044CrossRefPubMed

10.

Smit JG, Kasius JC, Eijkemans MJ, Veersema S, Fatemi HM, van Santbrink EJ, Campo R, Broekmans FJ (2013) The international agreement study on the diagnosis of the septate uterus at office hysteroscopy in infertile patients. Fertil Steril 99(2108–13):e2

11.

Dueholm M, Hjorth IM, Secher P, Jørgensen A, Ørtoft G (2015) Structured hysteroscopic evaluation of endometrium in women with postmenopausal bleeding. J Minim Invasive Gynecol 22:1215–1224CrossRefPubMed

12.

Bourdel N, Modaffari P, Tognazza E, Pertile R, Chauvet P, Botchorishivili R, Savary D, Pouly JL, Rabischong B, Canis M (2016) Does experience in hysteroscopy improve accuracy and inter-observer agreement in the management of abnormal uterine bleeding?. Surg Endosc (Epub ahead of print)

13.

Costa Santos C, Costa Pereira A, Bernardes J (2005) Agreement studies in obstetrics and gynaecology: inappropriateness, controversies and consequences. BJOG 112:667–669CrossRefPubMed

14.

Grant JM (1991) The fetal heart rate trace is normal, isn’t it? Observer agreement of categorical assessments. Lancet 337(8735):215–218CrossRefPubMed

15.

Kottner J, Audigé L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A, Roberts C, Shoukri M, Streiner DL (2011) Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. J Clin Epidemiol 64:96–106CrossRefPubMed

Title: Effect of clinical information and previous exam execution on observer agreement and reliability in the analysis of hysteroscopic video-recordings
Authors: Margarida Suzel Lopes Martinho
Cristina Maria Nogueira da Costa Santos
João Luís Mendonça Silva Carvalho
João Francisco Montenegro Andrade Lima Bernardes
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 2/2018
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4614-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of clinical information and previous exam execution on observer agreement and reliability in the analysis of hysteroscopic video-recordings

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2018

Maternal hemodynamics in late gestation and immediate postpartum in singletons vs. twin pregnancies

Ultrasound guided core needle biopsy prior to thermo ablative treatment of uterine tumors: first results

Assessment of ovarian function after chemotherapy in women with early and locally advanced breast cancer from Serbia

Stimulation of chemokines in human endometrial stromal cells by tumor necrosis factor-α and interferon-γ is similar under apoptotic and non-apoptotic conditions

Candidate biomarkers in the cervical vaginal fluid for the (self-)diagnosis of cervical precancer

Circulating levels of specific members of chromosome 19 microRNA cluster are associated with preeclampsia development