Inter-observer and intra-observer agreement on interpretation of uroflowmetry curves of kindergarten children

Abstract 

Purpose

To evaluate the inter-observer and intra-observer agreement on the interpretation of uroflowmetry curves of children.

Materials and methods

Healthy kindergarten children were enrolled for evaluation of uroflowmetry. Uroflowmetry curves were classified as bell-shaped, tower, plateau, staccato and interrupted. Only the bell-shaped curves were regarded as normal. Two urodynamists evaluated the curves independently after reviewing the definitions of the different types of uroflowmetry curve. The senior urodynamist evaluated the curves twice 3months apart. The final conclusion was made when consensus was reached. Agreement among observers was analyzed using kappa statistics.

Results

Of 190 uroflowmetry curves eligible for analysis, the intra-observer agreement in interpreting each type of curve and interpreting normalcy vs abnormality was good (kappa=0.71 and 0.68, respectively). Very good inter-observer agreement (kappa=0.81) on normalcy and good inter-observer agreement (kappa=0.73) on types of uroflowmetry were observed. Poor inter-observer agreement existed on the classification of specific types of abnormal uroflowmetry curves (kappa=0.07).

Conclusions

Uroflowmetry is a good screening tool for normalcy of kindergarten children, while not a good tool to define the specific types of abnormal uroflowmetry.

Keywords: Observer variation, Uroflowmetry, Children