Visual inspection of transvaginal ultrasound videos to characterize uterine peristalsis: an inter-observer agreement study

Purpose Contractions in non-pregnant uterine can be assessed by visual inspection of transvaginal ultrasound (TVUS). Many authors have used this method to extract features like contraction frequency and direction. However, visual inspection is a subjective method and the outcome is dependent on the sonographers and video analysts. In this study, we wanted to see which uterine feature is reproducible enough, in terms of inter-observer agreement, to serve as a reliable control for future research.

Six observers assessed 80 TVUS videos, and rated video quality, contraction frequency, direction and timing. One observer assessed operating time. A Fleiss’ kappa (κ) or an intra-class correlation (ICC) was calculated to determine the inter-observer agreement of all features.

The inter-observer agreement in frequency was substantial (ICC = 0.68). Conversely, there was just slight to fair agreement in contraction timing and direction and in video quality: ICC = 0.26, κ = 0.17 and κ = 0.16, respectively. Overall, agreement among technical engineers was better than between medical professionals. The level of agreement was correlated with video quality, phase of the menstrual cycle and individual patient (all χ2 with p < 0.00). The time to analyze one video ranged between 6 and 20 min.

This study shows that visual inspection of TVUS videos is a fairly reproducible method to assess contraction frequency. However, the operating time is too extensive to implement this method in daily practice. Automated methods could offer a solution for this problem in the future. Similar content being viewed by others

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We would like to thank Rudy de Roon, MSc, Michelle Hendrikx, MD, Rogier Wildeboer, MSc, Christina Caresio, PhD and Ruud van Sloun, PhD, for their help as observers and support in software development. Special thanks to Marcel van ‘t Veer, PhD for statistical support. Funding This research was funded by the Netherlands Organisation for Scientific Research (NOW) within the TTW domain (applied and technical sciences) in the form of a High Tech Systems and Materials grant (Grant number 13901). Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest The authors declare that they have no conflicts of interest. Ethical approval This research was approved by the medical ethical committee of the Catharina Hospital (MEC-U protocol number NL52466.100.15). Informed consent Informed consent was obtained from all individual participants included in the study. Data availability statement The data sets generated during and analyzed during the current study are available from the corresponding author on reasonable request. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Kuijsters, N.P.M., Sammali, F., Rabotti, C. et al. Visual inspection of transvaginal ultrasound videos to characterize uterine peristalsis: an inter-observer agreement study. J Ultrasound 23, 37–44 (2020). https://doi.org/10.1007/s40477-018-00356-z Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s40477-018-00356-z