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Error in histologic dating of secretory endometrium: variance component analysis
1University of Vermont College of Medicine, Burlington.
Objective:
To characterize the extent and sources of imprecision in histologic dating of the endometrial biopsy.
Design:
Duplicate endometrial biopsies from 25 women were dated by five evaluators on two separate occasions to evaluate the overall precision of the measure. Using variance component analysis, estimates of intrauterine, intraevaluator, and interevaluator variability were determined.
Setting:
Samples were obtained during outpatient fertility testing. Evaluators were colleagues at the same institution.
Patients, Participants:
Women presenting with infertility undergoing routine evaluation.
Interventions:
None.
Main Outcome Measure:
Variability in histologic dating of the endometrium.
Results:
Inconsistencies between evaluators accounted for 65% of the observed variability, whereas 27% was because of inconsistencies in duplicate readings by the same evaluator. Regional differences in the uterus accounted for only 8% of the total variability.
Conclusions:
The overall error from these sources have the potential to result in a substantial false-positive rate for diagnosis of luteal phase defect.
