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Published on: November 28, 2018
Interobserver reliability of microscopic assessment of saline-prepared vaginal fluid
James L Whiteside1, Themarge A Small, Todd A MacKenzie
1Department of Obstetrics and Gynecology, Dartmouth Medical School, Lebanon, NH 03756, USA. James.L.Whiteside@Hitchcock.org
Objective:
To determine the interobserver reliability of microscopic assessment of saline-prepared vaginal fluid.
Materials And Methods:
Blind-paired microscopic assessments of saline-prepared vaginal fluid collected from women presenting for gynecologic care were compared using concordance and weighted chance-corrected agreement statistics (κ).
Results:
Vaginal fluid from 105 women was collected and examined by 65 distinct observer pairs. The mean age of participants was 39 years, with vaginal itch (29%) followed by discharge (21%) as the most common presenting complaints. The κ value for microscopic findings ranged from 0.28 (normal flora) to 0.50 (clue cells >20%). The κ value for vaginitis diagnoses ranged from 0.25 (atrophic vaginitis) to 0.45 (bacterial vaginosis).
Conclusions:
Interobserver agreement in the microscopic assessment of vaginal fluid is at best moderate. The value of microscopy in the diagnosis of vaginitis is uncertain, and effort should be directed to improve the precision of this tool.
