title: Interrater reliability of assessing levator ani deficiency with 360° 3D endovaginal ultrasound.
abstract: OBJECTIVE
  Three-dimensional endovaginal ultrasound has been used for evaluation of levator ani muscle deficiency. The aim of this study was to assess interrater agreement/reliability of 3D endovaginal ultrasound for scoring levator ani deficiency (LAD).
  
  
  METHODS
  This was a cross-sectional study. Women referred to our urogynecology clinic for different pelvic floor dysfunction symptoms during November 2010-November 2012 were recruited. All patients underwent physical examination, including Pelvic Organ Prolapse Quantification (POP-Q) examination and high-resolution 3D endovaginal ultrasound. The levator muscle was divided into three subgroups based on our prior work: the puboperinealis/puboanalis (PA), puborectalis (PR), and iliococcygeus/pubococcygeus (PV). Subgroups were evaluated in their specific axial plane and were scored according to thickness and detachment from the pubic bone. Scoring was conducted by four raters blinded to case status and to one another's scores.
  
  
  RESULTS
  Ninety patients were recruited. The median age was 52 (range 24-86). Median body mass index (BMI) was 28.08 (range 17.08-51.39). Fifty percent of patients were menopausal. The range of exact agreement for total LAD score was 77-90 %. All the correlation coefficients at the individual sites as well as the overall scores were positive at above 0.63 and significant at <0.0001 level.
  
  
  CONCLUSIONS
  Our study demonstrates excellent agreement between raters assessing levator ani muscle deficiency using 3D endovaginal ultrasound. This level of concordance supports the reliability of the 3D endovaginal ultrasound technique and scoring method among raters [corrected].
authors: Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors: G
authors: G
authors: Rostaminia
authors: J
authors: J
authors: Manonai
authors: E
authors: E
authors: Leclaire
authors: F
authors: F
authors: Omoumi
authors: M
authors: M
authors: Marchiorlatti
authors: L H
authors: LH
authors: Quiroz
authors: S A
authors: SA
authors: Shobeiri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D019160:Endosonography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data*; D008875:Middle Aged; D015588:Observer Variation; D017773:Pelvic Floor / Q000503:physiopathology*; D015203:Reproducibility of Results; D014621:Vagina; D055815:Young Adult