Interobserver variability in the diagnosis of minimal and mild endometriosis

Olaf Buchweitz, Buchweitz O, Wülfing P, Pia Wülfing, P Wülfing, Malik E, Eduard Malik
European journal of obstetrics, gynecology, and reproductive biology · 2005 · vol. 122(2) , pp. 213–217 · doi:10.1016/j.ejogrb.2005.02.002 · PMID:16219522 · W1970324747
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This study assessed the agreement between different expert observers in diagnosing minimal and mild endometriosis based on surgical pathology reports.

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Abstract

Study objectiveTo evaluate the observer's influence on the diagnosis and classification of endometriosis according to the rASRM classification.Design: Prospective analysis.SettingUniversity hospital.PatientsDigital videotapes of laparoscopies in three patients with typical endometriotic disorders (rASRM I, II and no endometriosis).InterventionOne hundred and eight gynecologic surgeons were asked to indicate the endometriotic lesions on a prepared surgical sketch and to classify the site according to the rASRM classification.Measurements and main resultsTotal number, location and morphology of endometriotic lesions, rASRM classification. The interobserver correlation concerning the number of lesions ranged between 18% (rASRM II) and 30%. (rASRM I). There was marginal correlation regarding the location of endometriotic lesions. Kendall W coefficient ranged from 0.14 (rASRM II) to 0.44 (rASRM I) (p < 0.001). Only 13% (rASRM II) to 22% (rASRM I) of observers used the correct endometriotic classification. None of the participants specified the morphological characteristics of endometriotic lesions according to the rASRM classification.ConclusionVisual assessment of an operative situs with minimal and mild endometriosis is subject to a considerable interindividual variability. One and the same lesion is assessed quite differently by different observers. Histopathological verification seems to be necessary to objectify the diagnosis of endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometrium Gynecology Severity of Illness Index Biopsy Endometriosis Endometriosis Endometriosis Endometrium Female Gynecology Gynecology Humans Observer Variation Surveys and Questionnaires Videotape Recording

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