Inter-observer variability in the reporting of dynamic evacuation proctography.

Area of Science:

• Radiology
• Gastroenterology
• Pelvic Floor Imaging

Background:

• Dynamic evacuation proctography (DEP) is utilized for assessing pelvic floor dysfunction.
• Inter-observer variability can impact the reliability of diagnostic imaging interpretations.

Purpose of the Study:

• To quantify the inter-observer variability in the reporting of dynamic evacuation proctography (DEP).
• To assess the diagnostic consistency of DEP for specific pelvic floor abnormalities.

Main Methods:

• Retrospective analysis of 136 DEP videotapes reported by two independent observers.
• Assessment included presence/absence and size of anterior rectocoeles, intussusception, rectal prolapse, and non-relaxing puborectalis syndrome (NRPS).
• Inter-observer agreement was analyzed using the κ statistic.

Main Results:

• κ scores indicated good to excellent agreement for rectal prolapse (0.79) and anterior rectocoeles (0.82).
• Moderate agreement was observed for NRPS (0.70) and intussusception (0.54).
• Individual assessments of normal proctograms varied between observers (18% vs. 26%).

Conclusions:

• Dynamic evacuation proctography (DEP) demonstrates good inter-observer reproducibility for pelvic floor mechanics assessment.
• The findings support DEP as a reliable investigation with consistent reporting within the department.
• High agreement for key findings suggests clinical utility in diagnosing pelvic floor disorders.