Inter‐observer reproducibility of the 2021 \textlessspan style="font-variant:small-caps;"\textgreaterAAGL\textless/span\textgreater Endometriosis Classification. Mak, J. N., Uzuner, C., Espada, M., Eathorn, A., Reid, S., Leonardi, M., Armour, M., & Condous, G. S. Australian and New Zealand Journal of Obstetrics and Gynaecology, June, 2024. ![Inter‐observer reproducibility of the 2021 \textlessspan style="font-variant:small-caps;"\textgreaterAAGL\textless/span\textgreater Endometriosis Classification [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Background Inter‐observer agreement for the American Association of Gynecologic Laparoscopists (AAGL) 2021 Endometriosis Classification staging system has not been described. Its predecessor staging system, the revised American Society for Reproductive Medicine (rASRM), has historically demonstrated poor inter‐observer agreement. Aims We aimed to determine the inter‐observer agreement performance of the AAGL 2021 Endometriosis Classification staging system, and compare this with the rASRM staging system. Materials and Methods A database of 317 patients with coded surgical data was retrospectively analysed. Three independent observers allocated AAGL surgical stages (1–4), twice. Observers made their own interpretation of how to apply the tool in the first staging allocation. Consensus rules were then developed for a second staging allocation. Results First staging allocation: odds ratio (OR) (and 95% CI) for observer 1 to score higher than observer 2 was 8.08 (5.12–12.76). Observer 1 to score higher than observer 3 was 12.98 (7.99–21.11) and observer 2 to score higher than observer 3 was 1.61 (1.03–2.51). This represents poor agreement. Second staging allocation (after consensus): OR for observer 1 to score higher than observer 2 was 1.14 (0.64–2.03), observer 1 to score higher than observer 3 was 1.81 (0.99–3.28) and observer 2 to score higher than observer 3 was 1.59 (0.87–2.89). This represents good agreement. Conclusions These findings suggest that in its current format the AAGL 2021 Endometriosis Classification staging system has poor inter‐observer agreement, not superior to the rASRM staging system. However, performance improved when additional measures were taken to simplify and clarify areas of ambiguity in interpreting the staging system.
@article{mak_interobserver_2024,
title = {Inter‐observer reproducibility of the 2021 {\textless}span style="font-variant:small-caps;"{\textgreater}{AAGL}{\textless}/span{\textgreater} {Endometriosis} {Classification}},
issn = {0004-8666, 1479-828X},
shorttitle = {Inter‐observer reproducibility of the 2021 {\textless}span style="font-variant},
url = {https://obgyn.onlinelibrary.wiley.com/doi/10.1111/ajo.13851},
doi = {10.1111/ajo.13851},
abstract = {Background
Inter‐observer agreement for the American Association of Gynecologic Laparoscopists (AAGL) 2021 Endometriosis Classification staging system has not been described. Its predecessor staging system, the revised American Society for Reproductive Medicine (rASRM), has historically demonstrated poor inter‐observer agreement.
Aims
We aimed to determine the inter‐observer agreement performance of the AAGL 2021 Endometriosis Classification staging system, and compare this with the rASRM staging system.
Materials and Methods
A database of 317 patients with coded surgical data was retrospectively analysed. Three independent observers allocated AAGL surgical stages (1–4), twice. Observers made their own interpretation of how to apply the tool in the first staging allocation. Consensus rules were then developed for a second staging allocation.
Results
First staging allocation: odds ratio (OR) (and 95\% CI) for observer 1 to score higher than observer 2 was 8.08 (5.12–12.76). Observer 1 to score higher than observer 3 was 12.98 (7.99–21.11) and observer 2 to score higher than observer 3 was 1.61 (1.03–2.51). This represents poor agreement. Second staging allocation (after consensus): OR for observer 1 to score higher than observer 2 was 1.14 (0.64–2.03), observer 1 to score higher than observer 3 was 1.81 (0.99–3.28) and observer 2 to score higher than observer 3 was 1.59 (0.87–2.89). This represents good agreement.
Conclusions
These findings suggest that in its current format the AAGL 2021 Endometriosis Classification staging system has poor inter‐observer agreement, not superior to the rASRM staging system. However, performance improved when additional measures were taken to simplify and clarify areas of ambiguity in interpreting the staging system.},
language = {en},
urldate = {2024-08-11},
journal = {Australian and New Zealand Journal of Obstetrics and Gynaecology},
author = {Mak, Jason Nicholas and Uzuner, Cansu and Espada, Mercedes and Eathorn, Allie and Reid, Shannon and Leonardi, Mathew and Armour, Mike and Condous, George Stanley},
month = jun,
year = {2024},
pages = {ajo.13851},
}
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Its predecessor staging system, the revised American Society for Reproductive Medicine (rASRM), has historically demonstrated poor inter‐observer agreement. Aims We aimed to determine the inter‐observer agreement performance of the AAGL 2021 Endometriosis Classification staging system, and compare this with the rASRM staging system. Materials and Methods A database of 317 patients with coded surgical data was retrospectively analysed. Three independent observers allocated AAGL surgical stages (1–4), twice. Observers made their own interpretation of how to apply the tool in the first staging allocation. Consensus rules were then developed for a second staging allocation. Results First staging allocation: odds ratio (OR) (and 95% CI) for observer 1 to score higher than observer 2 was 8.08 (5.12–12.76). Observer 1 to score higher than observer 3 was 12.98 (7.99–21.11) and observer 2 to score higher than observer 3 was 1.61 (1.03–2.51). This represents poor agreement. Second staging allocation (after consensus): OR for observer 1 to score higher than observer 2 was 1.14 (0.64–2.03), observer 1 to score higher than observer 3 was 1.81 (0.99–3.28) and observer 2 to score higher than observer 3 was 1.59 (0.87–2.89). This represents good agreement. Conclusions These findings suggest that in its current format the AAGL 2021 Endometriosis Classification staging system has poor inter‐observer agreement, not superior to the rASRM staging system. However, performance improved when additional measures were taken to simplify and clarify areas of ambiguity in interpreting the staging system.","language":"en","urldate":"2024-08-11","journal":"Australian and New Zealand Journal of Obstetrics and Gynaecology","author":[{"propositions":[],"lastnames":["Mak"],"firstnames":["Jason","Nicholas"],"suffixes":[]},{"propositions":[],"lastnames":["Uzuner"],"firstnames":["Cansu"],"suffixes":[]},{"propositions":[],"lastnames":["Espada"],"firstnames":["Mercedes"],"suffixes":[]},{"propositions":[],"lastnames":["Eathorn"],"firstnames":["Allie"],"suffixes":[]},{"propositions":[],"lastnames":["Reid"],"firstnames":["Shannon"],"suffixes":[]},{"propositions":[],"lastnames":["Leonardi"],"firstnames":["Mathew"],"suffixes":[]},{"propositions":[],"lastnames":["Armour"],"firstnames":["Mike"],"suffixes":[]},{"propositions":[],"lastnames":["Condous"],"firstnames":["George","Stanley"],"suffixes":[]}],"month":"June","year":"2024","pages":"ajo.13851","bibtex":"@article{mak_interobserver_2024,\n\ttitle = {Inter‐observer reproducibility of the 2021 {\\textless}span style=\"font-variant:small-caps;\"{\\textgreater}{AAGL}{\\textless}/span{\\textgreater} {Endometriosis} {Classification}},\n\tissn = {0004-8666, 1479-828X},\n\tshorttitle = {Inter‐observer reproducibility of the 2021 {\\textless}span style=\"font-variant},\n\turl = {https://obgyn.onlinelibrary.wiley.com/doi/10.1111/ajo.13851},\n\tdoi = {10.1111/ajo.13851},\n\tabstract = {Background \n Inter‐observer agreement for the American Association of Gynecologic Laparoscopists (AAGL) 2021 Endometriosis Classification staging system has not been described. Its predecessor staging system, the revised American Society for Reproductive Medicine (rASRM), has historically demonstrated poor inter‐observer agreement. \n \n \n Aims \n We aimed to determine the inter‐observer agreement performance of the AAGL 2021 Endometriosis Classification staging system, and compare this with the rASRM staging system. \n \n \n Materials and Methods \n A database of 317 patients with coded surgical data was retrospectively analysed. Three independent observers allocated AAGL surgical stages (1–4), twice. Observers made their own interpretation of how to apply the tool in the first staging allocation. Consensus rules were then developed for a second staging allocation. \n \n \n Results \n First staging allocation: odds ratio (OR) (and 95\\% CI) for observer 1 to score higher than observer 2 was 8.08 (5.12–12.76). Observer 1 to score higher than observer 3 was 12.98 (7.99–21.11) and observer 2 to score higher than observer 3 was 1.61 (1.03–2.51). This represents poor agreement. Second staging allocation (after consensus): OR for observer 1 to score higher than observer 2 was 1.14 (0.64–2.03), observer 1 to score higher than observer 3 was 1.81 (0.99–3.28) and observer 2 to score higher than observer 3 was 1.59 (0.87–2.89). This represents good agreement. \n \n \n Conclusions \n These findings suggest that in its current format the AAGL 2021 Endometriosis Classification staging system has poor inter‐observer agreement, not superior to the rASRM staging system. However, performance improved when additional measures were taken to simplify and clarify areas of ambiguity in interpreting the staging system.},\n\tlanguage = {en},\n\turldate = {2024-08-11},\n\tjournal = {Australian and New Zealand Journal of Obstetrics and Gynaecology},\n\tauthor = {Mak, Jason Nicholas and Uzuner, Cansu and Espada, Mercedes and Eathorn, Allie and Reid, Shannon and Leonardi, Mathew and Armour, Mike and Condous, George Stanley},\n\tmonth = jun,\n\tyear = {2024},\n\tpages = {ajo.13851},\n}\n\n","author_short":["Mak, J. N.","Uzuner, C.","Espada, M.","Eathorn, A.","Reid, S.","Leonardi, M.","Armour, M.","Condous, G. 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