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Intraobserver and interobserver agreement in anal endosonography
D M Gold1, S Halligan, W A Kmiot
1Intestinal Imaging Centre, St Mark's Hospital, Harrow, UK.
The British Journal of Surgery
|April 14, 1999
Summary
Anal endosonography (AES) shows good agreement for diagnosing sphincter disruption. While measurements varied between observers, intraobserver agreement was better, defining measurement limits for anal canal structures.
Area of Science:
- Gastroenterology
- Medical Imaging
- Surgical Anatomy
Background:
- Anal endosonography (AES) is used to evaluate anal canal structures and sphincter integrity.
- Assessing the reliability of AES measurements and diagnoses is crucial for clinical application.
- Understanding variations in measurements and diagnoses between and within observers is essential.
Purpose of the Study:
- To determine intraobserver and interobserver agreement for sonographic measurements of anal canal structures using AES.
- To establish interobserver agreement for diagnosing anal sphincter disruption.
Main Methods:
- Fifty-one patients undergoing AES for suspected sphincter abnormalities were analyzed.
- Two independent observers reviewed studies, measuring anal canal structures and assessing sphincter integrity.
- Intraobserver and interobserver agreement were calculated for measurements and diagnostic assessments.
Main Results:
- Intraobserver agreement for measurements exceeded interobserver agreement.
- Interobserver limits of agreement were 5 mm for the external sphincter and 1.5 mm for the internal sphincter.
- Interobserver agreement was very good for diagnosing sphincter disruption (kappa = 0.80) and internal sphincter echogenicity (kappa = 0.74).
Conclusions:
- The study defined the limits of agreement for anal canal structure measurements using AES.
- Interobserver assessment of anal sphincter disruption via AES demonstrates very good reliability.