Abstract
Objective
To assess whether transvaginal sonographic measurements of bladder wall thickness
(BWT) have adequate reproducibility to detect differences in BWT potentially indicative
of detrusor overactivity in women with overactive bladder.
Study design
Three reproducibility studies were undertaken to assess (A) total measurement error,
(B) intra-observer variability and (C) inter-observer measurement in the interpretation
of scans. Women recruited to the Bladder Ultrasound Study underwent a transvaginal
ultrasound scan to obtain a measurement of BWT. When a second observer was available,
women who agreed to have two transvaginal scans by different operators were recruited
into study A. For study B the first observer reassessed a sample of the recorded images
at a later date whilst for study C, a random selection of BWT images were read by
a second assessor. Analytical variability, percentage of variability attributable
to measurement error, within-person variation and the smallest real difference detectable
were estimated.
Results
One hundred and twenty-one women took part: 27 had repeat scans, 37 had scans re-read
by the same observer, and 57 had scans read by two observers. In study A, 39% of the
total variability in measurements was explained by measurement error (the remainder
to within person change); the standard deviation (SD) of measurement error was 0.76 mm and the smallest detectable clinical difference was 2.1 mm. The SD of measurement error from scan interpretation was 0.42 mm within observers (study B) and 0.35 mm between observers (study C).
Conclusion
The high levels of measurement error for a small measurement of BWT means it is unlikely
Transvaginal ultrasound measurements have insufficient reliability and reproducibility
to be an accurate diagnostic test.
Keywords
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References
- An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction.Int Urogynecol J. 2010; 21: 5-26
- Prophylactic antibiotics to reduce the risk of urinary tract infections after urodynamic studies.Cochrane Database Syst Rev. 2012; 10: CD008224
- Ultrasound: a noninvasive screening test for detrusor instability.Br J Obstet Gynaecol. 1996; 103: 904-908
- Bladder ultrasonography for diagnosing detrusor overactivity: test accuracy study and economic evaluation.Health Technol Assess. 2016; 20: 1-150
- A novel technique for measuring bladder wall thickness in women using transvaginal ultrasound.Ultrasound Obstet Gynecol. 1994; 4: 220-223
- The case for using the repeatability coefficient when calculating test-retest reliability.PLoS One. 2013; 8: e73990
- Smallest real difference: a link between reproducibility and responsiveness.Qual Life Res. 2001; 10: 571-578
- Clinical usefulness of ultrasound assessment of detrusor wall thickness in patients with neurogenic lower urinary tract dysfunction due to spinal cord injury: urodynamics made easy?.World J Urol. 2013; 31: 659-664
- Measurement of detrusor wall thickness in women with overactive bladder by transvaginal and transabdominal sonography.Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20: 1293-1299
- Detrusor wall thickness as a test for detrusor overactivity in women.Ultrasound Obstet Gynecol. 2008; 32: 535-539
- Transvaginal ultrasound measurement of bladder wall thickness: a more reliable approach than transperineal and transabdominal approaches.BJU Int. 2010; 106: 1519-1522
- Inter and intra-reader variability of transvaginal bladder wall thickness measurements: results from the SHRINK study.ICS conference abstracts. 2013;
- An evaluation of the inter-observer and intra-observer variability of the ultrasound diagnosis of polycystic ovaries.Hum Reprod. 2002; 17: 1616-1622
Article info
Publication history
Published online: November 21, 2017
Accepted:
November 10,
2017
Received in revised form:
June 18,
2017
Received:
March 13,
2017
Identification
Copyright
© 2017 Published by Elsevier Ireland Ltd.
