Visual-Numeric Endometriosis Scoring System (VNESS) for mapping surgical findings: A validation study.

Objective The aim of this study was to assess inter-rater reliability for components of the Visual-Numeric Endometriosis Scoring System (VNESS). VNESS is a novel system for describing surgical findings in each compartment of the pelvis in a way that is simple to use, visually intuitive and mirrors a laparoscopic image of the pelvis. Design Validation study using short surgical laparoscopic video clips. Setting Anonymized video clips of endometriosis surgery scored by 50 Gynaecologists from 12 countries. Population Gynaecologists as scores of short surgical clips selected from a series of endometriosis procedures performed between 2012 and 2022. Methods 50 gynaecologists scored 93 short surgical videoclips using VNESS. 4650 scores were compared against a reference score and analysis was performed to assess inter-rater reliability. Main outcome measures The outcome measures were percentage agreement between given and reference scores, as well as intra-class correlation coefficients (ICC), Cohen Kappa and Quadratic Weighted Kappa Coefficients were calculated to evaluate inter-rater reliability. Results The highest and lowest percentage agreement with the reference score was seen in VNESS 4 (full thickness disease, 97% perfect agreement) and VNESS 1 (superficial disease, 53% perfect agreement) respectively. The intraclass correlation coefficient showed strong inter-rater reliability for all VNESS compartments except the vagina. Conclusions This study suggests that VNESS has excellent inter-observer reliability. Correlation is stronger with more severe disease.