title: Intrastomal 3D ultrasound; an inter- and intra-observer evaluation.
abstract: BACKGROUND
  The aim of this study was to determine intra- and interobserver reliability in 3D intrastomal ultrasound imaging of parastomal hernia and protrusion.
  
  
  METHODS
  A total of 40 patients were investigated. Two or three physicians evaluated the images twice, 1 month apart.
  
  
  RESULTS
  Inter-observer agreement was 72 % with a kappa value 0.59. For the last 10 patients there was an agreement of 80 % with a kappa value of 0.70. Intraobserver agreement was 80 % for one observer and 95 % for the other. The learning curve levelled out at around 30 patients.
  
  
  CONCLUSIONS
  Considering the learning curve of 30 patients, 3D intrastomal ultrasound is a reliable investigation method. 3D intrastomal ultrasonography has the potential to be the investigation of choice to differentiate between a bulge, a hernia, or a protrusion.
authors: Department of Surgery, Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Karolinska University Hospital/Huddinge, Stockholm, Sweden. karin.strigard@surgery.umu.se
authors: K
authors: K
authors: Strigård
authors: A
authors: A
authors: Gurmu
authors: P
authors: P
authors: Näsvall
authors: P
authors: P
authors: Påhlman
authors: U
authors: U
authors: Gunnarsson
mesh_terms: D015331:Cohort Studies; D003125:Colostomy; D046449:Hernia, Abdominal / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007081:Ileostomy; D021621:Imaging, Three-Dimensional; D059032:Learning Curve; D015588:Observer Variation; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D054047:Surgical Stomas; D014463:Ultrasonography