INTER-OBSERVER AGREEMENT IN INTERPRETING UROFLOWMETRY MEASUREMENTS IN INDONESIA

Abstract

Objective: We evaluated the comparability and repeatability of analyses based on uroflowmetry reports among urologists in Indonesia. Material & Methods: We assessed the inter-observer agreement when interpreting urodynamic examinations. Four urologists analyzed 20 sets of uroflowmetry data and gave their interpretations of the normality of the curve, reason of abnormality, grade classification, and pattern of the uroflowmetry curves. The consensus among observers was analyzed using the kappa statistic. Results: The kappa values for the analyses of the normality of the curves indicated fair to the moderate agreement. Agreement on the reason of abnormality showed poor to fair consensus. The shape of the flow curve had kappa values ranging from 0.047 to 0.225, indicating poor to fair consensus. Based on grade also showed kappa value from 0.047 to 0.169, indicating a poor agreement. Conclusion: Interpretations of uroflowmetry tracings showed only the poor to a fair agreement despite the normality of the uroflow curve. Variability in interpretation can strongly impact patient treatment. Therefore, further work is needed to standardize the reporting and interpretation of uroflowmetry studies to optimize patient care.

Keywords

• uroflowmetry
• observer variation
• inter-observer