Doppler Color Scoring System in Women With an Incomplete Miscarriage: Interobserver and Intraobserver Reproducibility Study.
color
first trimester
gynecology
incomplete miscarriage
observer variation
patient care
prospective studies
reproducibility of results
retained products of conception
sonography
Journal
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
ISSN: 1550-9613
Titre abrégé: J Ultrasound Med
Pays: England
ID NLM: 8211547
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
12
10
2018
revised:
10
12
2018
accepted:
21
12
2018
pubmed:
30
1
2019
medline:
11
2
2020
entrez:
30
1
2019
Statut:
ppublish
Résumé
Doppler Color Scoring (DCS) has been used to predict successful expectant management of incomplete miscarriage. The aim of this study was to assess inter- and intraobserver reproducibility of the DCS system in women with incomplete miscarriage noted on transvaginal sonography. This was a prospective reproducibility study involving offline analysis of 32 prerecorded video sets on transvaginal sonography in real time of women with incomplete miscarriage. Vascularization of retained products of conception was recorded using the DCS system adopted from the International Ovarian Tumor Analysis group. Five gynecologic sonologists of varying experience assigned a DCS classification to each video in the analysis. The same videos were reanalyzed, in a different order, at least 7 days later, to assess intraobserver agreement. Inter- and intraobserver correlations were performed to determine agreement. Interobserver agreement was also measured between each observer and the reference standard (G.C.). A Cohen's κ coefficient value less than 0 suggests poor agreement, 0.01 to 0.20 slight, 0.21 to 0.40 fair, 0.41 to 0.60 moderate, 0.61 to 0.80 substantial, and 0.81 and 0.99 almost perfect. Interobserver agreement for all observers for DCS allocation ranged from 0.480 to 0.751. Overall interobserver agreement for 5 observers was substantial (κ, 0.626). Overall interobserver agreements for the 2 inexperienced and 3 experienced observers compared to G.C. were 0.521 and 0.618, respectively. Experienced observers achieved overall almost perfect intraobserver agreement, compared to substantial agreement for inexperienced sonologists. DCS interobserver reproducibility between all observers and GC ranged from moderate to substantial. DCS intraobserver reproducibility was substantial to almost perfect. The DCS system appears to be a reproducible tool in evaluating women with incomplete miscarriage.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2437-2445Informations de copyright
© 2019 by the American Institute of Ultrasound in Medicine.
Références
Jurkovic D, Overton C, Bender-Atik R. Diagnosis and management of first trimester miscarriage. BMJ 2013; 346:f3676.
Luise C, Jermy K, May C, Costello G, Collins WP, Bourne TH. Outcome of expectant management of spontaneous first trimester miscarriage: observational study. BMJ 2002; 324:873-875.
Casikar I, Bignardi T, Riemke J, Alhamdan D, Condous G. Expectant management of spontaneous first-trimester miscarriage: prospective validation of the “2-week rule.” Ultrasound Obstet Gynecol 2010; 2:223-227.
Timmerman D, Valentin L, Bourne TH, Collins WP, Verrelst H, Vergote I. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet Gynecol 2000; 5:500-505.
Zannoni L, Savelli L, Jokubkiene L, et al. Intra- and interobserver reproducibility of assessment of Doppler ultrasound findings in adnexal masses. Ultrasound Obstet Gynecol 2013; 1:93-101.
Casikar I, Lu C, Oates J, Bignardi T, Alhamdan D, Condous G. The use of power Doppler colour scoring to predict successful expectant management in women with an incomplete miscarriage. Hum Reprod 2012; 3:669-675.
Kottner J, Audige L, Brorson S, et al. Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed. J Clin Epidemiol 2011; 1:96-106.
Al-Memar M, Kirk E, Bourne T. The role of ultrasonography in the diagnosis and management of early pregnancy complications. Obstet Gynaecol 2015; 17:173-181.
European Federation of Societies for Ultrasound in Medicine and Biology. Minimum training recommendations for the practice of medical ultrasound. Ultraschall Med 2006; 1:79-105.
Gwet Kilem L. Sample size determination 2010. http://agreestat.com/blog_irr/sample_size_determination.html. Updated June 28, 2010. Accessed May 2017.
Menakaya U, Infante F, Lu C, et al. Interpreting the real-time dynamic “sliding sign” and predicting pouch of Douglas obliteration: an interobserver, intraobserver, diagnostic-accuracy and learning-curve study. Ultrasound Obstet Gynecol 2016; 1:113-120.
National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management (CG154). NICE; December 12, 2012.