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Interobserver agreement in defecography--an international study

Muller-Lissner, S A; Bartolo, D C; Christiansen, J; Ekberg, Olle LU ; Goei, R; Hopfner, W; Infantino, A; Kuijpers, H C; Selvaggi, F and Wald, A (1998) In Zeitschrift für Gastroenterologie 36(4). p.273-279
Abstract
BACKGROUND: Defecography is considered to be an essential investigation in the evaluation of functional anorectal disorders, but the agreement between observers from different clinical centers has never been evaluated. METHODS: 14 defecographic studies were selected aimed to cover the most relevant defecographic findings responsible for disordered defecation. Eight studies were considered unequivocal, but six were thought to be controversial. All were sent to the ten participants in Europe and the US (five proctosurgeons, three radiologists, two gastroenterologists). They evaluated the studies using a previously agreed upon questionnaire. Interobserver agreement was quantified by kappa statistics and by the proportions of positive and... (More)
BACKGROUND: Defecography is considered to be an essential investigation in the evaluation of functional anorectal disorders, but the agreement between observers from different clinical centers has never been evaluated. METHODS: 14 defecographic studies were selected aimed to cover the most relevant defecographic findings responsible for disordered defecation. Eight studies were considered unequivocal, but six were thought to be controversial. All were sent to the ten participants in Europe and the US (five proctosurgeons, three radiologists, two gastroenterologists). They evaluated the studies using a previously agreed upon questionnaire. Interobserver agreement was quantified by kappa statistics and by the proportions of positive and negative agreement as compared to chance agreement, respectively. RESULTS: Overall, only the completeness of rectal emptying and the presence of a rectocele achieved acceptable kappa values above 0.4. When restricting the evaluation to the studies considered to be unequivocal, agreement improved considerably and was moderate to good for all items describing the images (kappa 0.43-0.63). However, whether proctosurgery should be performed and whether defecography contributed to the management of the particular patient remained controversial with very low kappa. CONCLUSIONS: It is doubtful whether defecography contributes substantially to the management of patients with disordered defecation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Zeitschrift für Gastroenterologie
volume
36
issue
4
pages
273 - 279
publisher
Georg Thieme Verlag
external identifiers
  • pmid:9612924
  • scopus:7144229365
ISSN
0044-2771
language
English
LU publication?
yes
id
094469ab-a490-42ac-8a3a-6f71014c78dc (old id 1113157)
date added to LUP
2008-07-14 13:28:08
date last changed
2017-01-01 07:25:59
@article{094469ab-a490-42ac-8a3a-6f71014c78dc,
  abstract     = {BACKGROUND: Defecography is considered to be an essential investigation in the evaluation of functional anorectal disorders, but the agreement between observers from different clinical centers has never been evaluated. METHODS: 14 defecographic studies were selected aimed to cover the most relevant defecographic findings responsible for disordered defecation. Eight studies were considered unequivocal, but six were thought to be controversial. All were sent to the ten participants in Europe and the US (five proctosurgeons, three radiologists, two gastroenterologists). They evaluated the studies using a previously agreed upon questionnaire. Interobserver agreement was quantified by kappa statistics and by the proportions of positive and negative agreement as compared to chance agreement, respectively. RESULTS: Overall, only the completeness of rectal emptying and the presence of a rectocele achieved acceptable kappa values above 0.4. When restricting the evaluation to the studies considered to be unequivocal, agreement improved considerably and was moderate to good for all items describing the images (kappa 0.43-0.63). However, whether proctosurgery should be performed and whether defecography contributed to the management of the particular patient remained controversial with very low kappa. CONCLUSIONS: It is doubtful whether defecography contributes substantially to the management of patients with disordered defecation.},
  author       = {Muller-Lissner, S A and Bartolo, D C and Christiansen, J and Ekberg, Olle and Goei, R and Hopfner, W and Infantino, A and Kuijpers, H C and Selvaggi, F and Wald, A},
  issn         = {0044-2771},
  language     = {eng},
  number       = {4},
  pages        = {273--279},
  publisher    = {Georg Thieme Verlag},
  series       = {Zeitschrift für Gastroenterologie},
  title        = {Interobserver agreement in defecography--an international study},
  volume       = {36},
  year         = {1998},
}