EP27.06: Interrater agreement for the prediction of pelvic adhesions and deep infiltrating endometriosis using specialised transvaginal ultrasound: a pilot study
Bibliographic record
Abstract
To determine interrater agreement for gynecologists with >10 years' experience in transvaginal ultrasound (TVU), upon adopting specialised TVU (S-TVU), for the prediction of ovarian mobility, uterine “sliding sign” (i.e. POD obliteration) and posterior compartment deep infiltrating endometriosis (DIE). Inter-rater reliability study performed at a tertiary referral centre for women with chronic pelvic pain (CPP). Two gynecologists, examiner 1 and examiner 2, with prior experience in TVU, underwent 20 and 13 supervised training sessions in S-TVU, respectively. S-TVU examinations were then performed independently by each examiner to assess for ovarian mobility, uterine “sliding sign” and posterior compartment DIE in women with CPP. Each S-TVU scan was first performed by examiner 1 or examiner 2, followed by the expert sonologist. The gold standard was the expert sonologist's S-TVU findings. Interrater reliability (i.e. Cohen's kappa) and percent agreement between each examiner and the expert was calculated. S-TVU results were available for 40 women. The expert's S-TVU findings were: 12/40 (30%) with posterior compartment DIE, 9/40(23%) with bowel DIE, 13/40 (33%) with POD obliteration, 23/40(58%) with ovarian immobility. Interrater agreement for gynecologists with limited experience in specialised TVU, compared to an expert sonologist, ranged from substantial to almost perfect for prediction of posterior compartment DIE and POD obliteration using the “sliding sign”, and from moderate to substantial for ovarian immobility.
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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 | 0.043 | 0.059 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".