Thiagamoorthy Ganesh, Zacchè Martino, Cardozo Linda, Naidu Madhu, Giarenis Ilias, Flint Richard, Srikrishna Sushma, Robinson Dudley
King's College Hospital, London, SE5 9RS, UK.
Croydon University Hospital, Croydon, CR7 7YE, UK.
Int Urogynecol J. 2016 Mar;27(3):433-7. doi: 10.1007/s00192-015-2841-3. Epub 2015 Sep 30.
Pelvic Organ Prolapse Quantification (POP-Q) system, measured in centimetres using a ruler (e.g. POPstix®), is recommended to quantify prolapse severity. POPstix® are costly (US $1/ruler). Home-made devices are used instead, but these have not been shown to be reproducible.
Digitally assessed POP-Q (DPOP-Q) is as reliable, reproducible and acceptable as POP-Q assessed using POPstix®.
In this randomised crossover diagnostic agreement trial, each assessor measured the index finger of their dominant hand using a ruler. At visit one, patients were randomised to either POPstix® POP-Q assessment in a modified lithotomy position or DPOP-Q in both modified a lithotomy and a standing position. After the first clinician conducted this assessment, a second blinded clinician then carried out the remaining assessment on the same patient. For each examination, duration was recorded, along with a patient-completed discomfort score. Twenty-five women were invited for visit two, at which DPOP-Q was recorded by the same clinician who undertook DPOP-Q at the first visit. This allowed evaluation of inter- and intraobserver agreement together with examination acceptability.
One hundred and nine women were recruited [median age 55 years, parity 2, body mass index (BMI) 27.1]. Of the 25 patients invited, 23 returned for visit two. DPOP-Q had high interobserver reliability [κ = 0.94, 95 % confidence interval (CI) 0.878-0.996] and intraobserver reliability (α = 0.96) with POPstix®. DPOP-Q was significantly quicker (p = 0.02) and less uncomfortable (p < 0.01) than POPstix® POP-Q.
DPOP-Q is reliable, acceptable and cost effective.
盆腔器官脱垂量化（POP-Q）系统建议使用直尺（如POPstix®）以厘米为单位进行测量，以量化脱垂严重程度。POPstix®价格昂贵（每把直尺1美元）。因此使用自制设备替代，但尚未证明这些设备具有可重复性。
数字评估的POP-Q（DPOP-Q）与使用POPstix®评估的POP-Q一样可靠、可重复且可接受。
在这项随机交叉诊断一致性试验中，每位评估者使用直尺测量其优势手的食指。在第一次就诊时，患者被随机分为在改良截石位进行POPstix® POP-Q评估或在改良截石位和站立位进行DPOP-Q评估。在第一位临床医生进行此评估后，第二位不知情的临床医生对同一患者进行其余评估。每次检查时，记录检查持续时间以及患者完成的不适评分。邀请25名女性参加第二次就诊，由在第一次就诊时进行DPOP-Q评估的同一位临床医生记录DPOP-Q。这使得能够评估观察者间和观察者内的一致性以及检查的可接受性。
招募了109名女性[中位年龄55岁，产次2，体重指数（BMI）27.1]。在邀请的25名患者中，23名返回参加第二次就诊。DPOP-Q与POPstix®相比具有较高的观察者间可靠性[κ = 0.94，95%置信区间（CI）0.878 - 0.996]和观察者内可靠性（α = 0.96）。DPOP-Q比POPstix® POP-Q显著更快（p = 0.02）且不适感更低（p < 0.01）。
DPOP-Q可靠、可接受且具有成本效益。
