title: Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size.
abstract: Inter-observer variation in andrological examination by 10 clinical investigators from five Nordic and Baltic countries was investigated. In addition, information on intra-observer variation was obtained for six of the 10 investigators. Testicular size was measured using Prader's orchidometer and one of the investigators also performed an ultrasound estimate of testicular size. A highly significant difference (p < 0.001) between observers was found with an inter-observer error of 16% in estimating testicular size in 23 young men. The difference in the estimate tended to increase with increasing testicular size. There was no significant intra-observer difference in two measurements performed on consecutive days. Only differences in median testis size, which were greater than 31% between measurements by two investigators, were found to be significant at the 5% level. The ultrasound estimate of testicular size was significantly lower than the orchidometer estimate, with a mean difference of 3.6 mL for the left testis and 4.3 mL for the right testis. Tanner staging of genitalia and diagnosis of a varicocele was subject to great inter-observer variation, and for the diagnosis of varicocele only one-third of the investigators was able to reproduce their results on a second examination. In conclusion, it was found that the clinical andrological examination of young men is subject to great inter-observer variation. This should be kept in mind when results from different studies are compared as well as in daily clinical practice.
authors.affiliation: Department of Growth and Reproduction, Copenhagen University Hospital, Denmark. rh03732@rh.dk
authors.forename: E
authors.initials: E
authors.lastname: Carlsen
authors.forename: A G
authors.initials: AG
authors.lastname: Andersen
authors.forename: L
authors.initials: L
authors.lastname: Buchreitz
authors.forename: N
authors.initials: N
authors.lastname: Jørgensen
authors.forename: O
authors.initials: O
authors.lastname: Magnus
authors.forename: V
authors.initials: V
authors.lastname: Matulevicuus
authors.forename: I
authors.initials: I
authors.lastname: Nermoen
authors.forename: J H
authors.initials: JH
authors.lastname: Petersen
authors.forename: M
authors.initials: M
authors.lastname: Punab
authors.forename: J
authors.initials: J
authors.lastname: Suominen
authors.forename: B
authors.initials: B
authors.lastname: Zilaitiene
authors.forename: A
authors.initials: A
authors.lastname: Giwercman
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D015588:Observer Variation; D009929:Organ Size; D013737:Testis / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014572:Urology