Interobserver variability in the diagnosis of minimal and mild endometriosis

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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 OBJECTIVE: To evaluate the observer's influence on the diagnosis and classification of endometriosis according to the rASRM classification. DESIGN: : Prospective analysis. SETTING: University hospital. PATIENTS: Digital videotapes of laparoscopies in three patients with typical endometriotic disorders (rASRM I, II and no endometriosis). INTERVENTION: One 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 RESULTS: Total 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. CONCLUSION: Visual 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 Severity of Illness Index Biopsy Biopsy Endometriosis Endometriosis Endometriosis Endometriosis Endometrium Endometrium Female Female Gynecology Gynecology Gynecology Humans Humans

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (26)

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License: CC0 · commercial use OK