Inter- and intra-rater reliability of fluoroscopic cough stress testing

The aim of this study was to assess inter- and intra-rater reliability in the interpretation of severity and type of stress urinary incontinence (SUI) during fluoroscopic cough stress testing. A total of 32 videourodynamic clips were selected from women presenting with stress, urge or mixed urinary incontinence. On two separate occasions, six urogynaecology healthcare professionals independently assessed the clips and classified the severity and type of SUI. Fleiss' and Cohen's kappa coefficients were calculated to assess strength of inter- and intra-rater reliability, respectively. Absolute inter-rater agreement for severity of SUI was observed in 24 of the 32 (75%) and 26 of the 32 (81%) cases for the first and second occasion, respectively. Absolute inter-rater agreement for type of SUI was seen in 16/32 cases (50%). Corresponding Fleiss' kappa coefficients supported reliability. Both the severity and, to a lesser degree, type of SUI assessed using fluoroscopic cough stress testing can be reliably interpreted.