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Uterin Kavitenin Değerlendirilmesinde Histeroskopinin Gözlemciler Arası Tutarlılığı

Yıl 2016, Cilt 13, Sayı 1, 4 - 7, 01.01.2016

Öz

Giriş: Benign uterin hastalık ön tanısı olan olguların uterin kavitelerinin değerlendirilmesinde histeroskopinin gözlemciler arası tutarlılığının araştırılmasıGereç ve Yöntemler: Çalışmamıza benign uterin hastalık ön tanısı nedeniyle histeroskopi yapılan olgular dahil edildi. Üç jinekolog tarafından histeroskopi işlemi sırasında elde edilen dijital görüntüler değerlendirdi. Gözlemciler arası tutarlılık Kappa istatistiği ile değerlendirildi. Toplu olarak eşitlenmiş kappa değeri olan sınıf içi korelasyon katsayısı, ortalama kappa değerlerinin hesaplanması için kullanıldı.Bulgular: Toplam 57 olgu çalışmaya dahil edildi. Histeroskopi işleminin gözlemciler arası tutarlılığı normal uterin kavite, endometrial polip, submüköz myom ve uterin subseptum tanısında zayıf ile orta derece arasında tutarlılık gösterdi ve sınıf içi korelasyon katsayısı sırasıyla 0.59, 0.60, 0.41, 0.32 olarak tespit edildi. Gözlemciler arası tutarlılık; anormal uterin kavite için orta tutarlılık düzeyinde ve endometrial polip tanısı için iyi tutarlılık düzeyinde, uterin subseptum için zayıf tutarlılık düzeyinde saptandı.Sonuç: Benignuterin hastalıkların tanısında, histeroskopinin gözlemciler arası tutarlılığı çalışmanın yapıldığı ortamda orta derecede saptanmıştır.

Kaynakça

  • Bettocchi S, Nappi L, Ceci O, Selvaggi L. Office hysteroscopy. Obstet Gynecol Clin North Am 2004;31:641–654.
  • Grimbizis GF, Tsolakidis D, Mikos T, Anagnostou E, Asimakopoulos E, Stamatopoulos P, et al..A prospective comparison of transvaginal ultra- sound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology.Fertil Steril 2010;942720-5.
  • Van DongenH, de Kroon CD, Jacobi CE, Trimbos JB, Jansen FW.Diag- nostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta-analysis.BJOG 2007;114:664-75.
  • Gimpelson RJ, Whalen TR. Hysteroscopy as gold standard for evaluati- on of abnormal uterine bleeding. Am J Obstet Gynecol 1995;173:1637- 8.
  • Kasius JC, Broekmans FJ, Veersema S, Eijkemans MJ, van Santbrink EJ, Devroey P et al.Observer agreement in the evaluation of the uterine cavity by hysteroscopy prior to in vitro fertilization.Hum Reprod 2011;26:801- 7.
  • Dueholm M, Lundorf E, Olesen F. Imaging techniques for evaluation of theuterine cavity and endometrium in premenopausal patients beforemi- nimally invasive surgery. Obstet Gynecol Surv 2002;57:388–403.
  • González-Becerra JE, Moreno-García JD, Leroy-López L, Gallardo LE.In- terobserver diagnostic agreement on digital images of hysteroscopicstu- dies.Gynecol Obstet Mex 2015;83:414-21.
  • Fleis, J.L. Statistical Methods for Rates and Proportions.1981; Wiley, New York.
  • Fleiss JL, Cohen J. The equivalence of weighted kappa and the intrac- lasscorrelation coefficient as measures of reliability. Educ Psychol Meas 1973;33:613–619.
  • Dueholm M, Hjorth IM, Secher P, Jİrgensen A, Ørtoft G.Reproducibility of endometrial pathologic findings obtained on hysteroscopy, transvagi- nal sonography, and gel infusion sonography in women with postmeno- pausal bleeding.J Minim Invasive Gynecol 2015;22:1036-44.

The Interobserver Agreement of The Hysteroscopy in Evaluation of Uterine Cavity

Yıl 2016, Cilt 13, Sayı 1, 4 - 7, 01.01.2016

Öz

Aim: To evaluate the inter-observer agreement of hysteroscopy procedures in the assessment of uterine cavity of patients with benign uterine disease.Material and Methods: Patients that underwent hysteroscopy procedures for benign uterine disease at our gynecology department were included into this prospective study. Three expert gynecologists evaluated the digitalized images of each patient. Kappa statistics were performed to assess the inter-observer agreement. The equivalent of the overall weighted Kappa κ values and the intra-class correlation coefficients ICC were applied to calculate the mean κ values.Results: Fifty-seven patients who underwent a hysteroscopy proceduredue to benign uterine pathology were enrolled. Reproducibility of the hysteroscopy procedure showed poor to moderate agreement for detection of normal uterine cavity, endometrial polyp, submucous myoma, uterus subseptus with ICCs values of 0.59, 0.60, 0.41, 0.32, respectively. The reproducibility of hysteroscopy was moderate for uterine cavity abnormalities. There was good agreement for the diagnosis of endometrial polyps, whereas this was poor for the diagnosis of uterus subseptus.Conclusion: Inter-observer agreement of hysteroscopy for the diagnosis of benign uterine conditions was generally moderate in our setting.

Kaynakça

  • Bettocchi S, Nappi L, Ceci O, Selvaggi L. Office hysteroscopy. Obstet Gynecol Clin North Am 2004;31:641–654.
  • Grimbizis GF, Tsolakidis D, Mikos T, Anagnostou E, Asimakopoulos E, Stamatopoulos P, et al..A prospective comparison of transvaginal ultra- sound, saline infusion sonohysterography, and diagnostic hysteroscopy in the evaluation of endometrial pathology.Fertil Steril 2010;942720-5.
  • Van DongenH, de Kroon CD, Jacobi CE, Trimbos JB, Jansen FW.Diag- nostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta-analysis.BJOG 2007;114:664-75.
  • Gimpelson RJ, Whalen TR. Hysteroscopy as gold standard for evaluati- on of abnormal uterine bleeding. Am J Obstet Gynecol 1995;173:1637- 8.
  • Kasius JC, Broekmans FJ, Veersema S, Eijkemans MJ, van Santbrink EJ, Devroey P et al.Observer agreement in the evaluation of the uterine cavity by hysteroscopy prior to in vitro fertilization.Hum Reprod 2011;26:801- 7.
  • Dueholm M, Lundorf E, Olesen F. Imaging techniques for evaluation of theuterine cavity and endometrium in premenopausal patients beforemi- nimally invasive surgery. Obstet Gynecol Surv 2002;57:388–403.
  • González-Becerra JE, Moreno-García JD, Leroy-López L, Gallardo LE.In- terobserver diagnostic agreement on digital images of hysteroscopicstu- dies.Gynecol Obstet Mex 2015;83:414-21.
  • Fleis, J.L. Statistical Methods for Rates and Proportions.1981; Wiley, New York.
  • Fleiss JL, Cohen J. The equivalence of weighted kappa and the intrac- lasscorrelation coefficient as measures of reliability. Educ Psychol Meas 1973;33:613–619.
  • Dueholm M, Hjorth IM, Secher P, Jİrgensen A, Ørtoft G.Reproducibility of endometrial pathologic findings obtained on hysteroscopy, transvagi- nal sonography, and gel infusion sonography in women with postmeno- pausal bleeding.J Minim Invasive Gynecol 2015;22:1036-44.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Selçuk SELÇUK
Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey


Şebnem TÜRKYILMAZ Bu kişi benim
Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey


Şeyma İÇÖZ Bu kişi benim
Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey


Masum KAYAPINAR Bu kişi benim
Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey


Mehmet KÜÇÜKBAŞ Bu kişi benim
Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey


Çetin ÇAM Bu kişi benim
Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey


Ateş KARATEKE Bu kişi benim
Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey

Yayımlanma Tarihi 1 Ocak 2016
Başvuru Tarihi 27 Eylül 2021
Kabul Tarihi 27 Eylül 2021
Yayınlandığı Sayı Yıl 2016, Cilt 13, Sayı 1

Kaynak Göster

Vancouver Selçuk S. , Türkyılmaz Ş. , İçöz Ş. , Kayapınar M. , Küçükbaş M. , Çam Ç. , Karateke A. Uterin Kavitenin Değerlendirilmesinde Histeroskopinin Gözlemciler Arası Tutarlılığı. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2016; 13(1): 4-7.