title: Interobserver agreement in assigning IOTA color score to adnexal masses using three-dimensional volumes or digital videoclips: potential implications for training.
abstract: OBJECTIVE
  To estimate the interobserver agreement between a trainer and trainees in assigning the International Ovarian Tumor Analysis (IOTA) color score to adnexal masses using three-dimensional (3D) volumes and videoclips.
  
  
  METHODS
  Fifty-one digital videoclips and 3D volumes of a non-consecutive series of adnexal masses were used for this study. One trainer and four trainees evaluated first the 3D volume and 1 week later a videoclip from the same mass. They had to assign IOTA color scores according to their impression of the amount of color content in each case. Interobserver agreement between trainer and trainees was assessed using Cohen's weighted kappa index with 95% CIs and percentage of agreement.
  
  
  RESULTS
  When using 3D volumes, interobserver agreement was good for three out of four pairs of comparisons and very good for one (kappa values of 0.70, 0.68, 0.81 and 0.71 for trainees A, B, C and D, respectively). When using videoclips, interobserver agreement was very good for two out of four pairs of comparisons and good for two (kappa values of 0.84, 0.80, 0.68 and 0.86 for Trainees A, B, C and D, respectively).
  
  
  CONCLUSIONS
  Evaluation of IOTA color scores in adnexal masses using either videoclips or 3D volumes is reproducible even in the hands of trainees after a short training program.
authors.affiliation: Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Pineda
authors.forename: E
authors.initials: E
authors.lastname: Salcedo
authors.forename: C
authors.initials: C
authors.lastname: Vilhena
authors.forename: L
authors.initials: L
authors.lastname: Juez
authors.forename: J L
authors.initials: JL
authors.lastname: Alcázar
mesh_terms: D000291:Adnexal Diseases / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D003116:Color; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D015588:Observer Variation; D015203:Reproducibility of Results; D018608:Ultrasonography, Doppler; D014741:Video Recording
keywords: adnexal mass; color Doppler; training; ultrasound