Abstract
We evaluated the inter- and intraobserver reproducibility of measuring five morphologic parameters of the anorectum in defecography (evacuation proctography). Measurements from 42 defecographic studies were statistically analyzed. The parameters measured during resting, squeezing, and straining included two anorectal angles (posterior and axis), maximal width of the anal canal, maximal width of the rectal lumen, and size of the rectocele. The results demonstrated only fair interobserver agreement (kappa = 0.22-0.38) for almost all measurements of the five morphologic parameters. There were high correlations (kappa = 0.62-1.00) among most intraobserver measurements. For defecographic measurement, the five parameters we studied have relatively poor clinical value because of high inter- and intraobserver inconsistency.
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