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Am J Obstet Gynecol. 2004 Jul;191(1):100-4.

Clinical evaluation of anterior vaginal wall support defects: interexaminer and intraexaminer reliability.

Author information

  • 1Department of Gynecology and Obstetrics, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. whitesj1@ccf.org

Abstract

OBJECTIVE:

The purpose of this study was to determine the interobserver and intraobserver reliability of the clinical examination of anterior vaginal wall support defects.

STUDY DESIGN:

Sixty-three patients with at least stage II anterior vaginal wall prolapse were prospectively evaluated with a standardized examination to detect anterior vaginal wall support defects. Interobserver reliability was assessed with a duplicate examination performed by a blinded second examiner. Intraobserver reliability was assessed with a second examination performed at least 3 weeks later by 1 of the original 2 examiners. Examination reliability for the 4 types of defects (central, right lateral, left lateral, and superior) was evaluated with the kappa statistic.

RESULTS:

The inter- and intraexaminer reliability of the clinical examination for central, superior, and right and left paravaginal defects was poor; all kappas were less than 0.50. Overall interexaminer agreement was 42% with a kappa of 0.16 (95% CI, 0-0.32). Overall intraexaminer agreement was 46% with a kappa of 0.16 (95% CI, 0-0.45). Reliability was noted to improve with increasing stage of prolapse.

CONCLUSION:

The clinical examination of anterior vaginal wall support defects displays poor interexaminer and intraexaminer agreement.

PMID:
15295349
[PubMed - indexed for MEDLINE]
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