Intraobserver and interobserver reliability of videotaped laparoscopy evaluations for endometriosis and adhesions

ObjectiveTo determine the intra- and interobserver reliability of evaluations during videotaped laparoscopy, with real-time laparoscopy as the “gold standard.”DesignProspective evaluation.SettingUniversity hospital.Patient(s)Women who underwent laparoscopy for chronic pelvic pain, sterilization, or infertility workup.Intervention(s)Real-time laparoscopies were videotaped and scored then later reassessed.Main Outcome Measure(s)Intra- and interobserver levels of agreement between evaluations for endometriosis and adhesions.Result(s)With the use of reassessments on 90 (videotaped) laparoscopies, the intra- and interobserver levels of agreement between the scorings for endometriosis were found to be substantial, except for ovarian implantations. A high agreement was found in the staging of endometriotic disease. The intra- and interobserver levels of agreement for scoring adhesions were only fair to moderate, and a substantial number of differences between measurements in adhesion total scores was found. No systematic difference between the number of disagreements was observed in either setting.Conclusion(s)Although special attention has to be given to the assessments of ovarian lesions, the evaluations of videotaped laparoscopies for endometriosis were reliable and justified the use of recorded findings. Because evaluations of adhesions during videotaped laparoscopy are not reliable, in some cases a second laparoscopy may need to be performed.