PWE-379 The measurement and assessment of rectocoele using ultrasound and proctography
Bibliographic record
Abstract
Introduction Defaecation proctography is the current gold standard for the evaluation of defaecatory dysfunction, which includes the assessment of rectocoele, but entails radiation exposure. Defaecation MRI is an alternative but is expensive and not easily available. Pelvic floor ultrasound is an emerging imaging modality for the assessment of pelvic floor pathology, including defaecatory dysfunction. This study aims to; - assess inter- and intra-rater repeatability of rectocoele assessment by both transperineal ultrasound (USS) and proctography - compare rectocoele assessment between the two imaging modalities. Method The images of 66 patients who had had undergone both USS and defaecatory proctography were retrospectively reviewed by four interpreters blinded to clinical symptoms and other imaging results. Transperineal ultrasound was performed on coughing, squeezing and bearing down. Defaecation proctography was performed with rectal and oral contrast. Rectocoele measurement on ultrasound was determined by the protrusion of the rectal wall beyond the perineal body into the vagina. Rectocoele measurement on proctography was the distance beyond a single line from the projected anterior rectal wall to the furthermost point of the rectocoele. Bland Altman analysis was performed to determine agreement. Results There was excellent inter and intra – rater agreement for rectocoele measurement on proctography (intra-class correlation coefficient 0.91 for both). There was excellent inter – rater agreement (intra-class correlation coefficient 0.78) and good intra - rater agreement (intra-class correlation coefficient 0.67) for rectocoele measurement on USS. There was moderate agreement between rectocoele measurement on ultrasound and that on proctography (intra-class correlation coefficient 0.46). There was a strong positive correlation between measurements on ultrasound compared to proctography (correlation coefficient 0.59). Rectocoele measurement was 1.25 cm larger on proctography than on ultrasound. Conclusion The measurement of rectocoeles on both proctography and ultrasound shows good to excellent inter – and intra – rater repeatability. There is a good correlation between measurements on ultrasound compared with proctography. Not surprisingly, measurements are larger using proctography where protrusion of the rectal wall is measured. By contrast ultrasound measures the protrusion over the perineal body into the vagina. Clearly, proctography may over-diagnose rectocoele. The next main consideration is how size on each modality correlates with function and clinical symptoms. Disclosure of interest None Declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".