VP05.17: Learning curve for the ultrasound detection of uterosacral ligaments and torus uterinus deep endometriosis: repeatability and reproducibility study

ANOVA gauge repeatability and reproducibility study is the most popular tool for measurement system analysis. Two experimental designs can be applied depending on the durability of the objects. If repeated measurements are possible or sufficient homogeneous nonrepeatable samples are available, crossed design is appropriate; otherwise, nested design should be used. In this paper, we investigated the adequacy of ANOVA gauge repeatability and reproducibility study from the perspective of practitioners. We proposed a Monte Carlo simulation that is close to the realistic procedure to evaluate the adequacy of both structures. During the evaluation, we considered the average performance metrics, percentage of correct decision, histogram shape, and symmetric mean absolute percentage error for the four popular performance metrics, namely, % Study Variation, % Contribution, % Tolerance, and the number of distinct categories. The experimental results show that the nested design fails to judge the precision of the gauge while the crossed design succeeds.

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Early Learning Curve in the Assessment of Deep Pelvic Endometriosis for Ultrasound and Magnetic Resonance Imaging

BioMed Research International ◽

10.1155/2020/8757281 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

T. Indrielle-Kelly ◽

D. Fischerova ◽

P. Hanuš ◽

F. Frühauf ◽

M. Fanta ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Learning Curve ◽

Uterosacral Ligament ◽

Learning Curves ◽

Pelvic Endometriosis ◽

Resonance Imaging ◽

Deep Endometriosis ◽

Kappa Agreement ◽

Radiology Trainee

Purpose. We aimed to compare the learning curves of an ultrasound trainee (obstetrics and gynecology resident) and a radiology trainee when assessing pelvic endometriosis. Methods. Consecutive patients with suspected endometriosis were prospectively enrolled in a tertiary center. They underwent an ultrasound and magnetic resonance imaging preoperatively, which was reported according to the International Deep Endometriosis Analysis (IDEA) group consensus. Trainees reported on deep endometriosis (DE), endometriomas, frozen pelvis, and adenomyosis. Using the Kappa agreement, their findings were compared against laparoscopy/histology and expert findings. The learning curve was considered positive when performance improved over time and indeterminate in all other cases. Results. Reports from thirty-five women were divided chronologically into 3 equal blocks to assess the learning curve. For ultrasound, trainee versus expert showed a positive learning curve in overall pelvic DE assessment. There was an excellent agreement for adenomyosis (Kappa=1.00, p=0.09), frozen pelvis (Kappa=0.90, p=0.01), bowel (Kappa=1.00, p=0.01), and bladder DE assessment (Kappa=1.00, p=0.01). Endometrioma and uterosacral ligament assessment showed an indeterminate curve. For radiology, trainee versus expert showed a positive curve when detecting adenomyosis (Kappa=0.42, p=0.09) and bladder DE (Kappa=1.00, p=0.01). The assessment of endometriomas, frozen pelvis, overall pelvic DE, bowel, and uterosacral ligament DE showed indeterminate curve. Agreement between trainees and laparoscopy/histology showed a positive curve for bladder (both) and frozen pelvis (ultrasound only). Conclusion. A positive learning curve can be seen in some areas of pelvic endometriosis mapping after as little as 35 cases, but a bigger caseload is required to demonstrate the curve in full. The ultrasound trainee had positive learning curves in more anatomical locations (bladder, adenomyosis, overall bowel DE, frozen pelvis) than the radiology trainee (bladder, adenomyosis), which could be down to individual factors, differences in training, or the imaging method itself.

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Does deep endometriosis infiltrating the uterosacral ligaments present an asymmetric lateral distribution?

British Journal of Obstetrics and Gynaecology ◽

10.1016/s0306-5456(01)00236-4 ◽

2001 ◽

Vol 108 (10) ◽

pp. 1021-1024 ◽

Cited By ~ 13

Author(s):

Charles Chapron ◽

Arnaud Fauconnier ◽

Jean-Bernard Dubuisson ◽

Marco Vieira ◽

Hélène Bonte ◽

...

Keyword(s):

Lateral Distribution ◽

Deep Endometriosis ◽

Uterosacral Ligaments

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Operative management of deep endometriosis infiltrating the uterosacral ligaments

The Journal of the American Association of Gynecologic Laparoscopists ◽

10.1016/s1074-3804(99)80037-1 ◽

1999 ◽

Vol 6 (1) ◽

pp. 31-37 ◽

Cited By ~ 71

Author(s):

Charles Chapron ◽

Jean-Bernard Dubuisson ◽

Xavier Fritel ◽

Bruno Fernandez ◽

Christophe Poncelet ◽

...

Keyword(s):

Operative Management ◽

Deep Endometriosis ◽

Uterosacral Ligaments

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Learning curve for the detection of pouch of Douglas obliteration and deep endometriosis of the rectum in gynaecological sonology trainees

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2019.07.351 ◽

2019 ◽

Vol 45 ◽

pp. S105-S106

Author(s):

Mathew Leonardi ◽

Ekavi Georgousopoulou ◽

Mercedes Espada ◽

Nicole Stamatopoulos ◽

Sally Lord ◽

...

Keyword(s):

Learning Curve ◽

Deep Endometriosis ◽

Pouch Of Douglas

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The Role of 3.0T MRI in the Assessment of Deep Endometriosis Located on the Uterosacral Ligaments

Journal of Endometriosis and Pelvic Pain Disorders ◽

10.5301/je.5000152 ◽

2013 ◽

Vol 5 (1) ◽

pp. 10-16 ◽

Cited By ~ 1

Author(s):

Lucia Manganaro ◽

Valeria Vinci ◽

Silvia Bernardo ◽

Paola Storelli ◽

Eliana Fuggetta ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Predictive Value ◽

Deep Infiltrating Endometriosis ◽

Ovarian Endometriosis ◽

Deep Endometriosis ◽

Uterosacral Ligaments ◽

3.0 T ◽

Magnetic Resonance Imaging Mri ◽

The Right

Purpose To assess the diagnostic accuracy of 3.0T magnetic resonance imaging (MRI) in assessing the involvement of uterosacral ligaments (USLs) in deep infiltrating endometriosis (DIE). Methods Between July 2010 and July 2012, 42 women, aged between 19 and 45 years (mean age 28 years), with a diagnosis of cystic ovarian endometriosis and scheduled for laparoscopic treatment, underwent pre-operative 3.0-T MRI examination. USL was considered normal when it was not visible or when it was thin and regular. Results We found USL involvement in 20/42 cases: 4/20 had bilateral involvement, 16/20 had monolateral involvement; in the right ligament in 9/16 cases and in the left in 7/16. Asymmetric morphology was found in 17 patients with an arciform shape associated with increased thickness of the ligament. A thickness >3 mm was considered positive. These patients also presented thickening of the torus uterinus region. In three cases complete cul de sac obliteration led to loss of tissue plane which hindered identification of the USLs. Comparison with laparoscopy findings enabled us to achieve the following statistical values: 94.7% sensitivity, 91.3% specificity, 90.0% positive predictive value, 95.4% negative predictive value, and 93% diagnostic accuracy. Conclusions Optimal visualization of USLs was obtained on para-axial scans on T2W and T1W sequences which allowed an optimal anatomic visualization. In our study we demonstrated that 3.0T imaging enabled an optimal assessment of USL involvement to select patients for the correct kind of surgery or follow-up of these patients.

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Guide for Conducting a Repeatability and Reproducibility Study on Test Equipment for Nondestructive Testing

10.1520/f1469-11 ◽

2011 ◽

Author(s):

Keyword(s):

Nondestructive Testing ◽

Test Equipment ◽

Reproducibility Study ◽

Repeatability And Reproducibility

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Measuring Uncertainty Using Different Approaches: A Case Study for Acetaminophen Quantification

Journal of AOAC International ◽

10.5740/jaoacint.15-0199 ◽

2016 ◽

Vol 99 (3) ◽

pp. 612-617 ◽

Cited By ~ 5

Author(s):

Fabiane Lacerda Francisco ◽

Alessandro Morais Saviano ◽

Felipe Rebello Lourenço

Keyword(s):

Measurement Uncertainty ◽

Uncertainty Estimation ◽

Pharmaceutical Drug ◽

Drug Products ◽

Pharmaceutical Equivalence ◽

Reproducibility Study ◽

Repeatability And Reproducibility ◽

Analytical Result ◽

Measurement Uncertainty Estimation

Abstract Investigation of out-of-specification analytical results is laborious, time-consuming, and costly and must be well documented. However, an analytical result is not complete unless reported with its measurement uncertainty. Here, we compare four different approaches for measurement uncertainty estimation used in acetaminophen quantification in pharmaceutical drug products. Measurement uncertainties were estimated using a repeatability and reproducibility study, Eurachem/Citac guidelines, Monte Carlo simulations, and a spreadsheet method. These different approaches provided similar results. However, they differed by the sources of uncertainties considered, by the procedures of calculation, and by the effort required in routine applications. Nevertheless, all four approaches were successful in assessing conformity of acetaminophen content in pharmaceutical drug products and may be used in assessing pharmaceutical equivalence.

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