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. 2004 Jul;191(1):100-4.
doi: 10.1016/j.ajog.2004.01.053.

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

James L Whiteside  1 , Matthew D Barber, Marie F Paraiso, Cathy M Hugney, Mark D Walters
Affiliations

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

James L Whiteside et al. Am J Obstet Gynecol. 2004 Jul.

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.

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