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Human Reproduction, Vol. 17, No. 6, 1616-1622, June 2002
© 2002 European Society of Human Reproduction and Embryology

An evaluation of the inter-observer and intra-observer variability of the ultrasound diagnosis of polycystic ovaries

S.A.K.S. Amer1, T.C. Li1,5, C. Bygrave2, A. Sprigg3, H. Saravelos4 and I.D. Cooke1

1 Department of Reproductive Medicine and Surgery, The Jessop Wing, Sheffield Teaching Hospitals NHS Trust, Tree Root Walk, Sheffield S10 2SF, 2 Department of Medical Physics & Clinical Technology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, 3 Department of Radiology, Sheffield Children's Hospital NHS Trust, Western Bank, Sheffield S10 2TH, UK and 4 University Department of Obstetrics and Gynecology, Hippokration Hospital, Aristotle University of Thessaloniki, 54008 Thessaloniki, Greece

BACKGROUND: This prospective observational study was undertaken to evaluate the reliability and consistency of ultrasound diagnosis of polycystic ovarian syndrome (PCOS). METHODS: Eighteen women with clinical and biochemical features suggestive of PCOS and nine normal control women underwent transvaginal ultrasound scan by a single ultrasonographer. The 27 ovarian scans were video-recorded and the recordings were later edited and arranged randomly so that each record appeared twice at random on the tape producing a total of 54 ovarian scans. Four experienced observers independently reviewed the recordings. The observers scored each case as follows: normal, possible polycystic ovary (PCO) and definite PCO. RESULTS: The mean intra-observer agreement was 69.4% ({kappa} = 0.54) and the mean inter-observer agreement was 51% ({kappa} = 0.28). CONCLUSION: The results suggest that the currently used ultrasonographic criteria for the diagnosis of polycystic ovaries do have significant intra-observer and inter-observer variability and as such must be considered subjective. Transvaginal ultrasonography alone may not therefore be a reliable method of diagnosing or excluding PCOS.

Key words: observer variability/polycystic ovaries/transvaginal scan

5 To whom correspondence should be addressed. E-mail: s.amer{at}sheffield.ac.uk


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