Visual inspection of transvaginal ultrasound videos to characterize uterine peristalsis: an inter‑observer agreement study

摘要

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 inspectionis a subjective method and the outcome is dependent on the sonographers and video analysts. In this study, we wantedto see which uterine feature is reproducible enough, in terms of inter-observer agreement, to serve as a reliable control forfuture research.Methods Six observers assessed 80 TVUS videos, and rated video quality, contraction frequency, direction and timing. Oneobserver assessed operating time. A Fleiss’ kappa (κ) or an intra-class correlation (ICC) was calculated to determine theinter-observer agreement of all features.Results The inter-observer agreement in frequency was substantial (ICC = 0.68). Conversely, there was just slight to fairagreement 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 correlatedwith video quality, phase of the menstrual cycle and individual patient (all χ~2 with p < 0.00). The time to analyze one videoranged between 6 and 20 min.Conclusions This study shows that visual inspection of TVUS videos is a fairly reproducible method to assess contractionfrequency. However, the operating time is too extensive to implement this method in daily practice. Automated methodscould offer a solution for this problem in the future.