Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons

Mathew Leonardi; Shannon Reid; Chuan Lu; Bassem Gerges; Tim Chang; Luk Rombauts; Martin Healey; Danny  Chou; Sarah Choi; Dheya Al-Mashat; Robert Magotti; Ralph Nader

doi:10.1016/j.jogc.2018.06.023

Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons

Standard

Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons. / Leonardi, Mathew; Reid, Shannon; Lu, Chuan et al.

In: Journal of Obstetrics and Gynaecology Canada, Vol. 41, No. 4, 01.04.2019, p. 443-449.e2.

Research output: Contribution to journal › Article › peer-review

Harvard

Leonardi, M, Reid, S, Lu, C, Gerges, B, Chang, T, Rombauts, L, Healey, M, Chou, D, Choi, S, Al-Mashat, D, Magotti, R & Nader, R 2019, 'Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons', Journal of Obstetrics and Gynaecology Canada, vol. 41, no. 4, pp. 443-449.e2. https://doi.org/10.1016/j.jogc.2018.06.023

APA

Leonardi, M., Reid, S., Lu, C., Gerges, B., Chang, T., Rombauts, L., Healey, M., Chou, D., Choi, S., Al-Mashat, D., Magotti, R., & Nader, R. (2019). Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons. Journal of Obstetrics and Gynaecology Canada, 41(4), 443-449.e2. https://doi.org/10.1016/j.jogc.2018.06.023

Vancouver

Leonardi M, Reid S, Lu C, Gerges B, Chang T, Rombauts L et al. Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons. Journal of Obstetrics and Gynaecology Canada. 2019 Apr 1;41(4):443-449.e2. Epub 2018 Oct 22. doi: 10.1016/j.jogc.2018.06.023

Author

Leonardi, Mathew ; Reid, Shannon ; Lu, Chuan et al. / Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons. In: Journal of Obstetrics and Gynaecology Canada. 2019 ; Vol. 41, No. 4. pp. 443-449.e2.

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@article{2458ca4c27604a3b8a34fe3568c3a3ce,

title = "Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons",

abstract = "ObjectiveKnowledge of rectouterine cul-de-sac state and consistent classification among surgeons are important in the surgical management of women with endometriosis. The objective of this study was to determine the diagnostic accuracy and interobserver and intraobserver agreement among general gynaecologists (GGs) and minimally invasive gynaecologic surgeons (MIGSs) in the prediction of cul-de-sac obliteration at off-line analysis of laparoscopic videos.MethodsFive GGs and five MIGSs viewed 33 prerecorded laparoscopic video sets off-line to determine cul-de-sac obliteration state (non-obliterated, partially obliterated, or completely obliterated) on two occasions (at least 7 days apart). Diagnostic accuracy and interobserver and intraobserver agreement were evaluated.ResultsThe interobserver agreements for all 10 observers for the description of cul-de-sac state ranged from fair to substantial agreement, with moderate overall agreement. MIGSs had slightly higher within-group interobserver agreement compared with GGs. MIGSs achieved overall almost perfect intraobserver agreement compared with substantial agreement for GGs. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for MIGSs classifying the cul-de-sac state were 83.9%, 88.5%, 88.5%, 89.2%, 92.0%, and 84.7%, respectively, whereas for GGs, they were 79.1%, 79.4%, 88.1%, 89.9%, and 76.1%, respectively.ConclusionDiagnostic accuracy and interobserver and intraobserver agreement for cul-de-sac obliteration state classification is acceptable in both groups. MIGSs had greater diagnostic accuracy and exhibited high interobserver and intraobserver agreement, a finding suggesting that their advanced training makes them more reliable in cul-de-sac obliteration assessment. Partial cul-de-sac obliteration was the most commonly incorrectly diagnosed state, thus implying that partial obliteration is not well understood.",

keywords = "rectouterine pouch, diagnostic accuracy, interobserver agreement, intraobserver agreement, reproducibility study",

author = "Mathew Leonardi and Shannon Reid and Chuan Lu and Bassem Gerges and Tim Chang and Luk Rombauts and Martin Healey and Danny Chou and Sarah Choi and Dheya Al-Mashat and Robert Magotti and Ralph Nader",

year = "2019",

month = apr,

day = "1",

doi = "10.1016/j.jogc.2018.06.023",

language = "English",

volume = "41",

pages = "443--449.e2",

journal = "Journal of Obstetrics and Gynaecology Canada",

issn = "1701-2163",

publisher = "Elsevier",

number = "4",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Diagnostic Accuracy and Reproducibility of Predicting Cul-de-Sac Obliteration by General Gynaecologists and Minimally Invasive Gynaecologic Surgeons

AU - Leonardi, Mathew

AU - Reid, Shannon

AU - Lu, Chuan

AU - Gerges, Bassem

AU - Chang, Tim

AU - Rombauts, Luk

AU - Healey, Martin

AU - Chou, Danny

AU - Choi, Sarah

AU - Al-Mashat, Dheya

AU - Magotti, Robert

AU - Nader, Ralph

PY - 2019/4/1

Y1 - 2019/4/1

N2 - ObjectiveKnowledge of rectouterine cul-de-sac state and consistent classification among surgeons are important in the surgical management of women with endometriosis. The objective of this study was to determine the diagnostic accuracy and interobserver and intraobserver agreement among general gynaecologists (GGs) and minimally invasive gynaecologic surgeons (MIGSs) in the prediction of cul-de-sac obliteration at off-line analysis of laparoscopic videos.MethodsFive GGs and five MIGSs viewed 33 prerecorded laparoscopic video sets off-line to determine cul-de-sac obliteration state (non-obliterated, partially obliterated, or completely obliterated) on two occasions (at least 7 days apart). Diagnostic accuracy and interobserver and intraobserver agreement were evaluated.ResultsThe interobserver agreements for all 10 observers for the description of cul-de-sac state ranged from fair to substantial agreement, with moderate overall agreement. MIGSs had slightly higher within-group interobserver agreement compared with GGs. MIGSs achieved overall almost perfect intraobserver agreement compared with substantial agreement for GGs. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for MIGSs classifying the cul-de-sac state were 83.9%, 88.5%, 88.5%, 89.2%, 92.0%, and 84.7%, respectively, whereas for GGs, they were 79.1%, 79.4%, 88.1%, 89.9%, and 76.1%, respectively.ConclusionDiagnostic accuracy and interobserver and intraobserver agreement for cul-de-sac obliteration state classification is acceptable in both groups. MIGSs had greater diagnostic accuracy and exhibited high interobserver and intraobserver agreement, a finding suggesting that their advanced training makes them more reliable in cul-de-sac obliteration assessment. Partial cul-de-sac obliteration was the most commonly incorrectly diagnosed state, thus implying that partial obliteration is not well understood.

AB - ObjectiveKnowledge of rectouterine cul-de-sac state and consistent classification among surgeons are important in the surgical management of women with endometriosis. The objective of this study was to determine the diagnostic accuracy and interobserver and intraobserver agreement among general gynaecologists (GGs) and minimally invasive gynaecologic surgeons (MIGSs) in the prediction of cul-de-sac obliteration at off-line analysis of laparoscopic videos.MethodsFive GGs and five MIGSs viewed 33 prerecorded laparoscopic video sets off-line to determine cul-de-sac obliteration state (non-obliterated, partially obliterated, or completely obliterated) on two occasions (at least 7 days apart). Diagnostic accuracy and interobserver and intraobserver agreement were evaluated.ResultsThe interobserver agreements for all 10 observers for the description of cul-de-sac state ranged from fair to substantial agreement, with moderate overall agreement. MIGSs had slightly higher within-group interobserver agreement compared with GGs. MIGSs achieved overall almost perfect intraobserver agreement compared with substantial agreement for GGs. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for MIGSs classifying the cul-de-sac state were 83.9%, 88.5%, 88.5%, 89.2%, 92.0%, and 84.7%, respectively, whereas for GGs, they were 79.1%, 79.4%, 88.1%, 89.9%, and 76.1%, respectively.ConclusionDiagnostic accuracy and interobserver and intraobserver agreement for cul-de-sac obliteration state classification is acceptable in both groups. MIGSs had greater diagnostic accuracy and exhibited high interobserver and intraobserver agreement, a finding suggesting that their advanced training makes them more reliable in cul-de-sac obliteration assessment. Partial cul-de-sac obliteration was the most commonly incorrectly diagnosed state, thus implying that partial obliteration is not well understood.

KW - rectouterine pouch

KW - diagnostic accuracy

KW - interobserver agreement

KW - intraobserver agreement

KW - reproducibility study

U2 - 10.1016/j.jogc.2018.06.023

DO - 10.1016/j.jogc.2018.06.023

M3 - Article

C2 - 30361156

VL - 41

SP - 443-449.e2

JO - Journal of Obstetrics and Gynaecology Canada