Interobserver agreement in the assessment of components of colposcopic grading.

Abstract

OBJECTIVE:

To estimate the reproducibility of the assessment of visual characteristics of cervical lesions used to judge lesion grade from colposcopy.

METHODS:

Digitized cervical images from 862 women enrolled in the ASCUS-LSIL Triage Study were obtained after application of 5% acetic acid. Each image was later assessed online by two randomly assigned evaluators from a pool of 20 experienced colposcopists. Interobserver agreement beyond chance was assessed by kappa statistics.

RESULTS:

Of 862 evaluable images with paired assessments, 607 were considered to have an acetowhite lesion by both evaluators, 171 by one, and 84 by neither. Kappa values (95% confidence intervals) for agreement were 0.22 (0.17-0.27) for color, 0.24 (0.18-0.30) for margins, 0.22 (0.16-0.29) for mosaicism, 0.17 (0.11-0.23) for punctation, 0.11 (0.00-0.22) for atypical vessels, and 0.26 (0.22-0.31) for modified Reid Index score.

CONCLUSION:

Characteristics used to assign colposcopic grade are poorly reproducible when used to assess static cervical images from women with borderline cytology results.

LEVEL OF EVIDENCE:

II.

• Authors: L Stewart Massad, Jose Jeronimo, Mark Schiffman, National Institutes of Health/American Society for Colposcopy and Cervical Pathology (NIH/ASCCP) Research Group
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 111 Issue 6 Pg. 1279-84 (Jun 2008) ISSN: 0029-7844 [Print] United States
• PMID: 18515509 (Publication Type: Journal Article)

Topics

• Colposcopy (standards)
• Female
• Humans
• Observer Variation
• Random Allocation
• Uterine Cervical Neoplasms (pathology)