Olaf Buchweitz1, Pia Wülfing, Eduard Malik. 1. Department of Obstetrics and Gynecology, University of Münster, Albert Schweitzer Str. 33, D-48149 Münster, Germany. buchweo@mednet.uni-muenster.de
Abstract
STUDY OBJECTIVE: To evaluate the observer's influence on the diagnosis and classification of endometriosis according to the rASRM classification. DESIGN: : Prospective analysis. SETTING: University hospital. PATIENTS: Digital videotapes of laparoscopies in three patients with typical endometriotic disorders (rASRM I, II and no endometriosis). INTERVENTION: One hundred and eight gynecologic surgeons were asked to indicate the endometriotic lesions on a prepared surgical sketch and to classify the site according to the rASRM classification. MEASUREMENTS AND MAIN RESULTS: Total number, location and morphology of endometriotic lesions, rASRM classification. The interobserver correlation concerning the number of lesions ranged between 18% (rASRM II) and 30%. (rASRM I). There was marginal correlation regarding the location of endometriotic lesions. Kendall W coefficient ranged from 0.14 (rASRM II) to 0.44 (rASRM I) (p < 0.001). Only 13% (rASRM II) to 22% (rASRM I) of observers used the correct endometriotic classification. None of the participants specified the morphological characteristics of endometriotic lesions according to the rASRM classification. CONCLUSION: Visual assessment of an operative situs with minimal and mild endometriosis is subject to a considerable interindividual variability. One and the same lesion is assessed quite differently by different observers. Histopathological verification seems to be necessary to objectify the diagnosis of endometriosis.
STUDY OBJECTIVE: To evaluate the observer's influence on the diagnosis and classification of endometriosis according to the rASRM classification. DESIGN: : Prospective analysis. SETTING: University hospital. PATIENTS: Digital videotapes of laparoscopies in three patients with typical endometriotic disorders (rASRM I, II and no endometriosis). INTERVENTION: One hundred and eight gynecologic surgeons were asked to indicate the endometriotic lesions on a prepared surgical sketch and to classify the site according to the rASRM classification. MEASUREMENTS AND MAIN RESULTS: Total number, location and morphology of endometriotic lesions, rASRM classification. The interobserver correlation concerning the number of lesions ranged between 18% (rASRM II) and 30%. (rASRM I). There was marginal correlation regarding the location of endometriotic lesions. Kendall W coefficient ranged from 0.14 (rASRM II) to 0.44 (rASRM I) (p < 0.001). Only 13% (rASRM II) to 22% (rASRM I) of observers used the correct endometriotic classification. None of the participants specified the morphological characteristics of endometriotic lesions according to the rASRM classification. CONCLUSION: Visual assessment of an operative situs with minimal and mild endometriosis is subject to a considerable interindividual variability. One and the same lesion is assessed quite differently by different observers. Histopathological verification seems to be necessary to objectify the diagnosis of endometriosis.
Authors: K C Schliep; Z Chen; J B Stanford; Y Xie; S L Mumford; A O Hammoud; E Boiman Johnstone; J K Dorais; M W Varner; G M Buck Louis; C M Peterson Journal: BJOG Date: 2015-10-05 Impact factor: 6.531
Authors: Germaine M Buck Louis; Zhen Chen; C Matthew Peterson; Mary L Hediger; Mary S Croughan; Rajeshwari Sundaram; Joseph B Stanford; Michael W Varner; Victor Y Fujimoto; Linda C Giudice; Ann Trumble; Patrick J Parsons; Kurunthachalam Kannan Journal: Environ Health Perspect Date: 2012-03-14 Impact factor: 9.031