[Interobserver diagnostic agreement on digital images of hysteroscopic studies]

Hysteroscopic studies are of the most used methods to examine the uterine cavity in patients that present abnormal uterine hemorrhage as well as those patients with infertility. The use of hysteroscopic studies during reproductive cycles has increased the successful of pregnancy rates. Up to date, there are not many studies evaluating the inter-observer agreement in the diagnosis of different uterine pathology when using a hysteroscopic study.

To evaluate the inter-observer agreement in the diagnosis of uterine pathology when using digitalized images in hysteroscopic studies made by residents of gynecological endoscopy.

A cross-sectional, descriptive and observational study was made including 28 images of hysteroscopic studies selected by at least two of three experts in hysteroscopy, who determined that they were adequate to do a diagnostic impresion. From a total of four residents, two were selected using a randomized sampling. The images were shown to each resident in a randomized presentation and the diagnosis agreement was evaluated. Kappa test was used to evaluate the interobserver agreement with 95% confidence interval.

The interobserver agreement obtained by Kappa test for different images for diagnosis of uterine pathology were: normal uterine cavity (κ = 0.81 with CI 95%, 0.56-1.00), endometrial polypus (κ = 0.71 with CI 95%, 0.33-1.00), submucous myoma (κ = 0.71 with Cl 95%, 0.33- 1.00), intrauterine adherences (κ = 0.84 with Cl 95%, 0.52-1.00), uterine septum (κ = 0.76 with CI 95%, 0.43-1.00) and endometrial hyperplasia or potential endometrial cancer (κ = 0.87 with Cl 95%, 0.61-1.00).

The interobserver agreement using digitalized images in the diagnosis of different uterine pathology from hysteroscopic studies made by residents of endoscopic surgery was high and very high in all cases.