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- Title
Reproducibility of the Endometriosis Fertility Index: a prospective inter-/intra-rater agreement study.
- Authors
Tomassetti, C; Bafort, C; Meuleman, C; Welkenhuysen, M; Fieuws, S; D'Hooghe, T
- Abstract
<bold>Objective: </bold>To evaluate the reproducibility of the Endometriosis Fertility Index (EFI).<bold>Design: </bold>Single-cohort prospective observational study.<bold>Setting: </bold>University hospital.<bold>Population: </bold>Women undergoing laparoscopic resection of any rASRM-stage endometriosis.<bold>Methods: </bold>Details of pre- and peroperative findings were collected into a coded research file. EFI scoring was performed en-bloc by three different raters (expert-1 [C.T.], expert-2 [C.M.], junior [C.B.]). Required sample size: 71. Definitions used for agreement: clinical (scores within same range: 0-4, 5-6, 7-10) and numerical (difference ≤1 EFI point).<bold>Main Outcome Measures: </bold>Primary outcome: rate of clinical agreement between two experts.<bold>Secondary Outcomes: </bold>expert numerical agreement, clinical and numerical agreement between expert-1 and junior, and within expert-1 (intra-observer), agreement of rASRM score and -stage.<bold>Results: </bold>A near 'inter-expert' clinical agreement rate (1.000, 95% CI 0.956-1.000; P = 0.0149) was observed. The numerical agreement between two experts was also high (0.988, 95% CI 0.934-1.000); similarly, high agreement rates were observed for both 'junior-expert' comparisons (clinical 0 .963, 95% CI 0.897-0.992; numerical 0.988, 95% CI 0.934-1.000) and 'intra-expert' comparisons (clinical 0.988, 95% CI 0.934-1.000; numerical 1.000, 95% CI 0.956-1.000). Reasons for disagreements were different scoring of the least-function score and disagreements in rASRM scores. The reproducibility of the rASRM score was clearly inferior to that of the EFI for all comparisons.<bold>Conclusion: </bold>The EFI can be reproduced reliably by different raters, further supporting its use in daily clinical practice as the principal clinical tool for postoperative fertility counselling/management of women with endometriosis.<bold>Tweetable Abstract: </bold>A study confirming the high reproducibility of the EFI substantiates its use in daily clinical practice.
- Subjects
ENDOMETRIOSIS; FERTILITY; LAPAROSCOPIC surgery; WOMEN executives; INFERTILITY; LAPAROSCOPY; LONGITUDINAL method; RESEARCH funding; RESEARCH bias; SEVERITY of illness index; DISEASE complications
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2020, Vol 127, Issue 1, p107
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.15880