TY - JOUR
T1 - Observer agreement in the evaluation of the uterine cavity by hysteroscopy prior to in vitro fertilization
AU - Kasius, JC
AU - Broekmans, FJM
AU - Veersema, S
AU - Eijkemans, Rene
AU - van Santbrink, Evert
AU - Devroey, P
AU - Fauser, BCJM (Bart)
AU - Fatemi, HM
PY - 2011
Y1 - 2011
N2 - BACKGROUND: Hysteroscopy is known as the most accurate test for diagnosing intrauterine pathology. To optimize fertility treatment, it is increasingly common to perform hysteroscopy as a routine procedure prior to IVF. However, literature on the reproducibility of screening hysteroscopy is lacking. Therefore, the aim of the study was to assess the intra-and inter-observer agreement in the individual evaluation of the uterine cavity using video recordings of hysteroscopy procedures in asymptomatic patients prior to IVF. METHODS: Screening hysteroscopies of 123 unselected, asymptomatic, infertile women with an indication for IVF/ICSI treatment were recorded on DVD. After editing, the hysteroscopy performer and three other experienced gynecologists independently assessed all recordings, focusing on the appearance of predefined intrauterine abnormalities (i.e. endometrial polyps, myomas, adhesions or septa). The intra- and inter-observer agreement was calculated and expressed as perfect agreement and kappa coefficient or intraclass correlation coefficient. RESULTS: In total, 123 hysteroscopy procedures were recorded. After editing and selection, based on the record quality, 107 remained for assessment and analysis. The intraobserver agreement on the appearance of any of the predefined intrauterine abnormalities was substantial (kappa = 0.707), whereas the interobserver agreement was moderate (kappa = 0.491). Perfect agreement occurred only in 77.6% of the cases. CONCLUSIONS: Interobserver agreement among experienced gynecologists appeared to be rather disappointing. The latter may have implications for the diagnostic accuracy of screening hysteroscopy prior to IVF, as well as for its clinical significance in IVF programs.
AB - BACKGROUND: Hysteroscopy is known as the most accurate test for diagnosing intrauterine pathology. To optimize fertility treatment, it is increasingly common to perform hysteroscopy as a routine procedure prior to IVF. However, literature on the reproducibility of screening hysteroscopy is lacking. Therefore, the aim of the study was to assess the intra-and inter-observer agreement in the individual evaluation of the uterine cavity using video recordings of hysteroscopy procedures in asymptomatic patients prior to IVF. METHODS: Screening hysteroscopies of 123 unselected, asymptomatic, infertile women with an indication for IVF/ICSI treatment were recorded on DVD. After editing, the hysteroscopy performer and three other experienced gynecologists independently assessed all recordings, focusing on the appearance of predefined intrauterine abnormalities (i.e. endometrial polyps, myomas, adhesions or septa). The intra- and inter-observer agreement was calculated and expressed as perfect agreement and kappa coefficient or intraclass correlation coefficient. RESULTS: In total, 123 hysteroscopy procedures were recorded. After editing and selection, based on the record quality, 107 remained for assessment and analysis. The intraobserver agreement on the appearance of any of the predefined intrauterine abnormalities was substantial (kappa = 0.707), whereas the interobserver agreement was moderate (kappa = 0.491). Perfect agreement occurred only in 77.6% of the cases. CONCLUSIONS: Interobserver agreement among experienced gynecologists appeared to be rather disappointing. The latter may have implications for the diagnostic accuracy of screening hysteroscopy prior to IVF, as well as for its clinical significance in IVF programs.
U2 - 10.1093/humrep/der003
DO - 10.1093/humrep/der003
M3 - Article
C2 - 21310749
SN - 0268-1161
VL - 26
SP - 801
EP - 807
JO - Human Reproduction
JF - Human Reproduction
IS - 4
ER -