Intra‐ and Inter‐Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study
Objectives To evaluate the intra‐ and inter‐rater agreement for myometrial lesions using Morphologic Uterus Sonographic Assessment terminology. Methods Thirteen raters with high (n = 6) or medium experience (n = 7) assessed 30 3‐dimensional ultrasound clips with (n = 20) and without (n = 10) benign...
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| Veröffentlicht in: | Journal of ultrasound in medicine 2019-10, Vol.38 (10), p.2673-2683 |
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| creator | Rasmussen, Christina Kjaergaard Van den Bosch, Thierry Exacoustos, Caterina Manegold‐Brauer, Gwendolin Benacerraf, Beryl R. Froyman, Wouter Landolfo, Chiara Condorelli, Margherita Egekvist, Anne G. Josefsson, Hampus Leone, Francesco Paolo Giuseppe Jokubkiene, Ligita Zannoni, Letizia Epstein, Elisabeth Installé, Arnaud Dueholm, Margit |
| description | Objectives
To evaluate the intra‐ and inter‐rater agreement for myometrial lesions using Morphologic Uterus Sonographic Assessment terminology.
Methods
Thirteen raters with high (n = 6) or medium experience (n = 7) assessed 30 3‐dimensional ultrasound clips with (n = 20) and without (n = 10) benign myometrial lesions. Myometrial lesions were reported as poorly or well defined and then systematically evaluated for the presence of individual features. The clips were blindly assessed twice (at a 2‐month interval). Intra‐ and inter‐rater agreements were calculated with κ statistics.
Results
The reporting of poorly defined lesions reached moderate intra‐rater agreement (κ = 0.49 [high experience] and 0.47 [medium experience]) and poor inter‐rater agreement (κ = 0.39 [high experience] and 0.25 [medium experience]). The reporting of well‐defined lesions reached good to very good intra‐rater agreement (κ = 0.73 [high experience] and 0.82 [medium experience]) and good inter‐rater agreement (κ = 0.75 [high experience] and 0.63 [medium experience]). Most individual features associated with ill‐defined lesions reached moderate intra‐ and inter‐rater agreement among highly experienced raters (κ = 0.41–0.60). The least reproducible features were myometrial cysts, hyperechoic islands, subendometrial lines and buds, and translesional flow (κ = 0.11–0.34). Most individual features associated with well‐defined lesions reached moderate to good intra‐ and inter‐rater agreement among all observers (κ = 0.41–0.80). The least reproducible features were a serosal contour, asymmetry, a hyperechoic rim, and fan‐shaped shadows (κ = 0.00–0.35).
Conclusions
The reporting of well‐defined lesions showed excellent agreement, whereas the agreement for poorly defined lesions was low, even among highly experienced raters. The agreement on identifying individual features varied, especially for features associated with ill‐defined lesions. Guidelines on minimum requirements for features associated with ill‐defined lesions to be interpreted as poorly defined lesions may improve agreement. |
| doi_str_mv | 10.1002/jum.14971 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_481712</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2185873879</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3981-62c84013e54b7f2da906a521258a7ee220d969e07397406cc0bd853e5007dd5f3</originalsourceid><addsrcrecordid>eNp1kctO3DAUhi1UVKbQBS9QedkuArZzsd3diAIFDQKVztpykjODaRIHn0RoduUN-ox9khoysOvq3L7zbX5CDjk74oyJ4_uxPeKZlnyHzHies0QXPH1HZkxIlWRCyz3yAfE-oozL7D3ZS5mKXZHNyNNFNwT79_cfaruaxgFCHH7YWOl8HQBa6Ab6DbAKrnTdml5tfAtDcLahC0DnO6RLfDn40N_5xq9dRZfxfUR66zu_Dra_i6s5IiA-277SOb1xjR_o7TDWmwOyu7INwsdt3SfLs9OfJ9-TxfX5xcl8kVSpVjwpRKUyxlPIs1KuRG01K2wuuMiVlQBCsFoXGphMtcxYUVWsrFUeccZkXeerdJ8kkxcfoR9L0wfX2rAx3jqzXf2KHZhMcclF5D9PfB_8wwg4mNZhBU1jO_AjGsFVrmSqpI7olwmtgkcMsHqTc2aeEzIxIfOSUGQ_bbVj2UL9Rr5GEoHjCXh0DWz-bzKXy6tJ-Q8s_J3Z</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2185873879</pqid></control><display><type>article</type><title>Intra‐ and Inter‐Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Rasmussen, Christina Kjaergaard ; Van den Bosch, Thierry ; Exacoustos, Caterina ; Manegold‐Brauer, Gwendolin ; Benacerraf, Beryl R. ; Froyman, Wouter ; Landolfo, Chiara ; Condorelli, Margherita ; Egekvist, Anne G. ; Josefsson, Hampus ; Leone, Francesco Paolo Giuseppe ; Jokubkiene, Ligita ; Zannoni, Letizia ; Epstein, Elisabeth ; Installé, Arnaud ; Dueholm, Margit</creator><creatorcontrib>Rasmussen, Christina Kjaergaard ; Van den Bosch, Thierry ; Exacoustos, Caterina ; Manegold‐Brauer, Gwendolin ; Benacerraf, Beryl R. ; Froyman, Wouter ; Landolfo, Chiara ; Condorelli, Margherita ; Egekvist, Anne G. ; Josefsson, Hampus ; Leone, Francesco Paolo Giuseppe ; Jokubkiene, Ligita ; Zannoni, Letizia ; Epstein, Elisabeth ; Installé, Arnaud ; Dueholm, Margit</creatorcontrib><description>Objectives
To evaluate the intra‐ and inter‐rater agreement for myometrial lesions using Morphologic Uterus Sonographic Assessment terminology.
Methods
Thirteen raters with high (n = 6) or medium experience (n = 7) assessed 30 3‐dimensional ultrasound clips with (n = 20) and without (n = 10) benign myometrial lesions. Myometrial lesions were reported as poorly or well defined and then systematically evaluated for the presence of individual features. The clips were blindly assessed twice (at a 2‐month interval). Intra‐ and inter‐rater agreements were calculated with κ statistics.
Results
The reporting of poorly defined lesions reached moderate intra‐rater agreement (κ = 0.49 [high experience] and 0.47 [medium experience]) and poor inter‐rater agreement (κ = 0.39 [high experience] and 0.25 [medium experience]). The reporting of well‐defined lesions reached good to very good intra‐rater agreement (κ = 0.73 [high experience] and 0.82 [medium experience]) and good inter‐rater agreement (κ = 0.75 [high experience] and 0.63 [medium experience]). Most individual features associated with ill‐defined lesions reached moderate intra‐ and inter‐rater agreement among highly experienced raters (κ = 0.41–0.60). The least reproducible features were myometrial cysts, hyperechoic islands, subendometrial lines and buds, and translesional flow (κ = 0.11–0.34). Most individual features associated with well‐defined lesions reached moderate to good intra‐ and inter‐rater agreement among all observers (κ = 0.41–0.80). The least reproducible features were a serosal contour, asymmetry, a hyperechoic rim, and fan‐shaped shadows (κ = 0.00–0.35).
Conclusions
The reporting of well‐defined lesions showed excellent agreement, whereas the agreement for poorly defined lesions was low, even among highly experienced raters. The agreement on identifying individual features varied, especially for features associated with ill‐defined lesions. Guidelines on minimum requirements for features associated with ill‐defined lesions to be interpreted as poorly defined lesions may improve agreement.</description><identifier>ISSN: 0278-4297</identifier><identifier>EISSN: 1550-9613</identifier><identifier>DOI: 10.1002/jum.14971</identifier><identifier>PMID: 30801764</identifier><language>eng</language><publisher>England</publisher><subject>adenomyosis ; Adult ; Female ; fibromas ; gynecology ; Humans ; Imaging, Three-Dimensional - methods ; Middle Aged ; Myometrium - diagnostic imaging ; observer variability ; Observer Variation ; Pilot Projects ; Prospective Studies ; Reproducibility of Results ; Ultrasonography - methods ; ultrasound ; Uterine Neoplasms - diagnostic imaging</subject><ispartof>Journal of ultrasound in medicine, 2019-10, Vol.38 (10), p.2673-2683</ispartof><rights>2019 by the American Institute of Ultrasound in Medicine</rights><rights>2019 by the American Institute of Ultrasound in Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3981-62c84013e54b7f2da906a521258a7ee220d969e07397406cc0bd853e5007dd5f3</citedby><cites>FETCH-LOGICAL-c3981-62c84013e54b7f2da906a521258a7ee220d969e07397406cc0bd853e5007dd5f3</cites><orcidid>0000-0003-1813-1028</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjum.14971$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjum.14971$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30801764$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:141938125$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Rasmussen, Christina Kjaergaard</creatorcontrib><creatorcontrib>Van den Bosch, Thierry</creatorcontrib><creatorcontrib>Exacoustos, Caterina</creatorcontrib><creatorcontrib>Manegold‐Brauer, Gwendolin</creatorcontrib><creatorcontrib>Benacerraf, Beryl R.</creatorcontrib><creatorcontrib>Froyman, Wouter</creatorcontrib><creatorcontrib>Landolfo, Chiara</creatorcontrib><creatorcontrib>Condorelli, Margherita</creatorcontrib><creatorcontrib>Egekvist, Anne G.</creatorcontrib><creatorcontrib>Josefsson, Hampus</creatorcontrib><creatorcontrib>Leone, Francesco Paolo Giuseppe</creatorcontrib><creatorcontrib>Jokubkiene, Ligita</creatorcontrib><creatorcontrib>Zannoni, Letizia</creatorcontrib><creatorcontrib>Epstein, Elisabeth</creatorcontrib><creatorcontrib>Installé, Arnaud</creatorcontrib><creatorcontrib>Dueholm, Margit</creatorcontrib><title>Intra‐ and Inter‐Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study</title><title>Journal of ultrasound in medicine</title><addtitle>J Ultrasound Med</addtitle><description>Objectives
To evaluate the intra‐ and inter‐rater agreement for myometrial lesions using Morphologic Uterus Sonographic Assessment terminology.
Methods
Thirteen raters with high (n = 6) or medium experience (n = 7) assessed 30 3‐dimensional ultrasound clips with (n = 20) and without (n = 10) benign myometrial lesions. Myometrial lesions were reported as poorly or well defined and then systematically evaluated for the presence of individual features. The clips were blindly assessed twice (at a 2‐month interval). Intra‐ and inter‐rater agreements were calculated with κ statistics.
Results
The reporting of poorly defined lesions reached moderate intra‐rater agreement (κ = 0.49 [high experience] and 0.47 [medium experience]) and poor inter‐rater agreement (κ = 0.39 [high experience] and 0.25 [medium experience]). The reporting of well‐defined lesions reached good to very good intra‐rater agreement (κ = 0.73 [high experience] and 0.82 [medium experience]) and good inter‐rater agreement (κ = 0.75 [high experience] and 0.63 [medium experience]). Most individual features associated with ill‐defined lesions reached moderate intra‐ and inter‐rater agreement among highly experienced raters (κ = 0.41–0.60). The least reproducible features were myometrial cysts, hyperechoic islands, subendometrial lines and buds, and translesional flow (κ = 0.11–0.34). Most individual features associated with well‐defined lesions reached moderate to good intra‐ and inter‐rater agreement among all observers (κ = 0.41–0.80). The least reproducible features were a serosal contour, asymmetry, a hyperechoic rim, and fan‐shaped shadows (κ = 0.00–0.35).
Conclusions
The reporting of well‐defined lesions showed excellent agreement, whereas the agreement for poorly defined lesions was low, even among highly experienced raters. The agreement on identifying individual features varied, especially for features associated with ill‐defined lesions. Guidelines on minimum requirements for features associated with ill‐defined lesions to be interpreted as poorly defined lesions may improve agreement.</description><subject>adenomyosis</subject><subject>Adult</subject><subject>Female</subject><subject>fibromas</subject><subject>gynecology</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional - methods</subject><subject>Middle Aged</subject><subject>Myometrium - diagnostic imaging</subject><subject>observer variability</subject><subject>Observer Variation</subject><subject>Pilot Projects</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Ultrasonography - methods</subject><subject>ultrasound</subject><subject>Uterine Neoplasms - diagnostic imaging</subject><issn>0278-4297</issn><issn>1550-9613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctO3DAUhi1UVKbQBS9QedkuArZzsd3diAIFDQKVztpykjODaRIHn0RoduUN-ox9khoysOvq3L7zbX5CDjk74oyJ4_uxPeKZlnyHzHies0QXPH1HZkxIlWRCyz3yAfE-oozL7D3ZS5mKXZHNyNNFNwT79_cfaruaxgFCHH7YWOl8HQBa6Ab6DbAKrnTdml5tfAtDcLahC0DnO6RLfDn40N_5xq9dRZfxfUR66zu_Dra_i6s5IiA-277SOb1xjR_o7TDWmwOyu7INwsdt3SfLs9OfJ9-TxfX5xcl8kVSpVjwpRKUyxlPIs1KuRG01K2wuuMiVlQBCsFoXGphMtcxYUVWsrFUeccZkXeerdJ8kkxcfoR9L0wfX2rAx3jqzXf2KHZhMcclF5D9PfB_8wwg4mNZhBU1jO_AjGsFVrmSqpI7olwmtgkcMsHqTc2aeEzIxIfOSUGQ_bbVj2UL9Rr5GEoHjCXh0DWz-bzKXy6tJ-Q8s_J3Z</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Rasmussen, Christina Kjaergaard</creator><creator>Van den Bosch, Thierry</creator><creator>Exacoustos, Caterina</creator><creator>Manegold‐Brauer, Gwendolin</creator><creator>Benacerraf, Beryl R.</creator><creator>Froyman, Wouter</creator><creator>Landolfo, Chiara</creator><creator>Condorelli, Margherita</creator><creator>Egekvist, Anne G.</creator><creator>Josefsson, Hampus</creator><creator>Leone, Francesco Paolo Giuseppe</creator><creator>Jokubkiene, Ligita</creator><creator>Zannoni, Letizia</creator><creator>Epstein, Elisabeth</creator><creator>Installé, Arnaud</creator><creator>Dueholm, Margit</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><orcidid>https://orcid.org/0000-0003-1813-1028</orcidid></search><sort><creationdate>201910</creationdate><title>Intra‐ and Inter‐Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study</title><author>Rasmussen, Christina Kjaergaard ; Van den Bosch, Thierry ; Exacoustos, Caterina ; Manegold‐Brauer, Gwendolin ; Benacerraf, Beryl R. ; Froyman, Wouter ; Landolfo, Chiara ; Condorelli, Margherita ; Egekvist, Anne G. ; Josefsson, Hampus ; Leone, Francesco Paolo Giuseppe ; Jokubkiene, Ligita ; Zannoni, Letizia ; Epstein, Elisabeth ; Installé, Arnaud ; Dueholm, Margit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3981-62c84013e54b7f2da906a521258a7ee220d969e07397406cc0bd853e5007dd5f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>adenomyosis</topic><topic>Adult</topic><topic>Female</topic><topic>fibromas</topic><topic>gynecology</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional - methods</topic><topic>Middle Aged</topic><topic>Myometrium - diagnostic imaging</topic><topic>observer variability</topic><topic>Observer Variation</topic><topic>Pilot Projects</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Ultrasonography - methods</topic><topic>ultrasound</topic><topic>Uterine Neoplasms - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rasmussen, Christina Kjaergaard</creatorcontrib><creatorcontrib>Van den Bosch, Thierry</creatorcontrib><creatorcontrib>Exacoustos, Caterina</creatorcontrib><creatorcontrib>Manegold‐Brauer, Gwendolin</creatorcontrib><creatorcontrib>Benacerraf, Beryl R.</creatorcontrib><creatorcontrib>Froyman, Wouter</creatorcontrib><creatorcontrib>Landolfo, Chiara</creatorcontrib><creatorcontrib>Condorelli, Margherita</creatorcontrib><creatorcontrib>Egekvist, Anne G.</creatorcontrib><creatorcontrib>Josefsson, Hampus</creatorcontrib><creatorcontrib>Leone, Francesco Paolo Giuseppe</creatorcontrib><creatorcontrib>Jokubkiene, Ligita</creatorcontrib><creatorcontrib>Zannoni, Letizia</creatorcontrib><creatorcontrib>Epstein, Elisabeth</creatorcontrib><creatorcontrib>Installé, Arnaud</creatorcontrib><creatorcontrib>Dueholm, Margit</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Journal of ultrasound in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rasmussen, Christina Kjaergaard</au><au>Van den Bosch, Thierry</au><au>Exacoustos, Caterina</au><au>Manegold‐Brauer, Gwendolin</au><au>Benacerraf, Beryl R.</au><au>Froyman, Wouter</au><au>Landolfo, Chiara</au><au>Condorelli, Margherita</au><au>Egekvist, Anne G.</au><au>Josefsson, Hampus</au><au>Leone, Francesco Paolo Giuseppe</au><au>Jokubkiene, Ligita</au><au>Zannoni, Letizia</au><au>Epstein, Elisabeth</au><au>Installé, Arnaud</au><au>Dueholm, Margit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intra‐ and Inter‐Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study</atitle><jtitle>Journal of ultrasound in medicine</jtitle><addtitle>J Ultrasound Med</addtitle><date>2019-10</date><risdate>2019</risdate><volume>38</volume><issue>10</issue><spage>2673</spage><epage>2683</epage><pages>2673-2683</pages><issn>0278-4297</issn><eissn>1550-9613</eissn><abstract>Objectives
To evaluate the intra‐ and inter‐rater agreement for myometrial lesions using Morphologic Uterus Sonographic Assessment terminology.
Methods
Thirteen raters with high (n = 6) or medium experience (n = 7) assessed 30 3‐dimensional ultrasound clips with (n = 20) and without (n = 10) benign myometrial lesions. Myometrial lesions were reported as poorly or well defined and then systematically evaluated for the presence of individual features. The clips were blindly assessed twice (at a 2‐month interval). Intra‐ and inter‐rater agreements were calculated with κ statistics.
Results
The reporting of poorly defined lesions reached moderate intra‐rater agreement (κ = 0.49 [high experience] and 0.47 [medium experience]) and poor inter‐rater agreement (κ = 0.39 [high experience] and 0.25 [medium experience]). The reporting of well‐defined lesions reached good to very good intra‐rater agreement (κ = 0.73 [high experience] and 0.82 [medium experience]) and good inter‐rater agreement (κ = 0.75 [high experience] and 0.63 [medium experience]). Most individual features associated with ill‐defined lesions reached moderate intra‐ and inter‐rater agreement among highly experienced raters (κ = 0.41–0.60). The least reproducible features were myometrial cysts, hyperechoic islands, subendometrial lines and buds, and translesional flow (κ = 0.11–0.34). Most individual features associated with well‐defined lesions reached moderate to good intra‐ and inter‐rater agreement among all observers (κ = 0.41–0.80). The least reproducible features were a serosal contour, asymmetry, a hyperechoic rim, and fan‐shaped shadows (κ = 0.00–0.35).
Conclusions
The reporting of well‐defined lesions showed excellent agreement, whereas the agreement for poorly defined lesions was low, even among highly experienced raters. The agreement on identifying individual features varied, especially for features associated with ill‐defined lesions. Guidelines on minimum requirements for features associated with ill‐defined lesions to be interpreted as poorly defined lesions may improve agreement.</abstract><cop>England</cop><pmid>30801764</pmid><doi>10.1002/jum.14971</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-1813-1028</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of ultrasound in medicine, 2019-10, Vol.38 (10), p.2673-2683 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | adenomyosis Adult Female fibromas gynecology Humans Imaging, Three-Dimensional - methods Middle Aged Myometrium - diagnostic imaging observer variability Observer Variation Pilot Projects Prospective Studies Reproducibility of Results Ultrasonography - methods ultrasound Uterine Neoplasms - diagnostic imaging |
| title | Intra‐ and Inter‐Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study |
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