Evaluation of Inter-examiner Reliability Using a Drinking-ultrasonography Examination

Purpose: We developed a drinking-ultrasonography examination (drinking US) which is a combination of a drink test and ultrasonography to assess gastric motility and sensory function of functional dyspepsia (FD) patients. However, it is known that ultrasonography (US) is lack of objectivity and requires sonographic skills and substantial experience. The purpose of this study was to evaluate the inter-examiner reliability of a drinking US. Subjects and Methods: 8 healthy volunteers were enrolled in this study. A drinking US was performed after a subject had fasted. The subjects ingested 200 ml of water at two minutes intervals for 4 times (total ingested water amount was 800 ml) through a straw. The maximum cross sectional view of the proximal stomach was visualized and measured the area of the stomach by US, before water intake, after each 200 ml water intake. Abdominal symptoms were evaluated using the visual analog scale (VAS) in each time. Three sonographers performed a drinking US for each volunteer in random order without knowing the findings and images of drinking US. Interclass correlation coefficients (ICC2.1) were used to estimate reliability. Results and Discussion: The ICC at the time of each water intake 200 ml, 400 ml, 600 ml and 800 ml were 0.22, 0.36, 0.14 and 0.43 respectively. It seems that there were some reasons causing low reproducibility affected by the effect of gastrointestinal gas in volunteers. Conclusion: Inter-examiner reliability of a drinking-ultrasonography test was good in clinical use, it was possible to properly perform in any examiner.