N P M Kuijsters1,2, F Sammali3, C Rabotti3, Y Huang3, M Mischi3, B C Schoot3,4,5. 1. Department of Electrical Engineering (Signal Processing Systems: Biomedical Diagnostics), Faculty of Electrical Engineering, Eindhoven Technical University, FLUX Room 7.078, Postbox 513, 5600 MB, Eindhoven, The Netherlands. nienkekuijsters@live.nl. 2. Department of Obstetrics and Gynecology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. nienkekuijsters@live.nl. 3. Department of Electrical Engineering (Signal Processing Systems: Biomedical Diagnostics), Faculty of Electrical Engineering, Eindhoven Technical University, FLUX Room 7.078, Postbox 513, 5600 MB, Eindhoven, The Netherlands. 4. Department of Obstetrics and Gynecology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. 5. Department of Obstetrics and Gynecology, University Hospital (UZ) Gent, C. Heymanslaan 10, 9000, Ghent, Belgium.
Abstract
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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Marianne Dreyer Holt; Agnieszka Katarzyna Warzecha; Nathalie Søderhamn Bülow; Sven Olaf Skouby; Anne Lis Mikkelsen Englund; Kathrine Birch Petersen; Nicholas Stephen Macklon Journal: Hum Reprod Open Date: 2022-03-08