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Digital assessment and quantification of pelvic organ prolapse (DPOP-Q): a randomised cross-over diagnostic agreement trial

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Abstract

Introduction

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.

Hypothesis

Digitally assessed POP-Q (DPOP-Q) is as reliable, reproducible and acceptable as POP-Q assessed using POPstix®.

Methods

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.

Results

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.

Conclusion

DPOP-Q is reliable, acceptable and cost effective.

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Conflict of interest

G Thiagamoorthy has received funding from Astellas and Johnson & Johnson to attend conferences; also received an IUGA FRN grant to set up a multicentre research project. M Zacchè has received funding from Astellas to attend conferences. L Cardozo received funding for research, lecturing and/or advice/consultancies from Allergan, Astellas & Pfizer. M Naidu has received funding from Astellas to attend conferences. I Giarenis has received funding from Astellas and Johnson & Johnson to attend conferences. R Flint has no conflicts. S Srikrishna has received funding for lecturing and/or advice/consultancies from Astellas. D Robinson has received funding for research, lecturing and/or advice/consultancies from Allergan, Astellas, Ferring & Pfizer.

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Authors and Affiliations

  1. King’s College Hospital, London, SE5 9RS, UK

    Ganesh Thiagamoorthy, Martino Zacchè, Linda Cardozo, Ilias Giarenis, Richard Flint, Sushma Srikrishna & Dudley Robinson

  2. Croydon University Hospital, Croydon, CR7 7YE, UK

    Madhu Naidu

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  1. Ganesh Thiagamoorthy
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  2. Martino Zacchè
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  3. Linda Cardozo
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  4. Madhu Naidu
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  5. Ilias Giarenis
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  6. Richard Flint
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  7. Sushma Srikrishna
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  8. Dudley Robinson
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Correspondence to Ganesh Thiagamoorthy.

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Thiagamoorthy, G., Zacchè, M., Cardozo, L. et al. Digital assessment and quantification of pelvic organ prolapse (DPOP-Q): a randomised cross-over diagnostic agreement trial. Int Urogynecol J 27, 433–437 (2016). https://doi.org/10.1007/s00192-015-2841-3

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  • DOI: https://doi.org/10.1007/s00192-015-2841-3

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