{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T01:42:58Z","timestamp":1793497378713,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,2,7]],"date-time":"2018-02-07T00:00:00Z","timestamp":1517961600000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007478","name":"International Osteoporosis Foundation","doi-asserted-by":"publisher","award":["13\u20100260"],"award-info":[{"award-number":["13\u20100260"]}],"id":[{"id":"10.13039\/501100007478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate intra\u2010 and interrater agreement and reliability with regard to describing ultrasound images of the endometrium using the International Endometrial Tumor Analysis (IETA) terminology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four expert and four non\u2010expert raters assessed videoclips of transvaginal ultrasound examinations of the endometrium obtained from 99 women with postmenopausal bleeding and sonographic endometrial thickness \u2265\u20094.5\u2009mm but without fluid in the uterine cavity. The following features were rated: endometrial echogenicity, endometrial midline, bright edge, endometrial\u2013myometrial junction, color score, vascular pattern, irregularly branching vessels and color splashes. The color content of the endometrial scan was estimated using a visual analog scale graded from 0 to 100. To estimate intrarater agreement and reliability, the same videoclips were assessed twice with a minimum of 2\u2009months' interval. The raters were blinded to their own results and to those of the other raters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Interrater differences in the described prevalence of most IETA variables were substantial, and some variable categories were observed rarely. Specific agreement was poor for variables with many categories. For binary variables, specific agreement was better for absence than for presence of a category. For variables with more than two outcome categories, specific agreement for expert and non\u2010expert raters was best for not\u2010defined endometrial midline (93% and 96%), regular endometrial\u2013myometrial junction (72% and 70%) and three\u2010layer endometrial pattern (67% and 56%). The grayscale ultrasound variable with the best reliability was uniform <jats:italic>vs<\/jats:italic> non\u2010uniform echogenicity (multirater kappa (\u03ba), 0.55 for expert and 0.52 for non\u2010expert raters), and the variables with the lowest reliability were appearance of the endometrial\u2013myometrial junction (\u03ba, 0.25 and 0.16) and the nine\u2010category endometrial echogenicity variable (\u03ba, 0.29 and 0.28). The most reliable color Doppler variable was color score (mean weighted \u03ba, 0.77 and 0.69). Intra\u2010 and interrater agreement and reliability were similar for experts and non\u2010experts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Inter\u2010 and intrarater agreement and reliability when using IETA terminology were limited. This may have implications when assessing the association between a particular ultrasound feature and a specific histological diagnosis, because lack of reproducibility reduces the reliability of the association between a feature and the outcome. Future studies should investigate whether using fewer categories of variable or offering practical training could improve agreement and reliability. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.18813","type":"journal-article","created":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T13:09:48Z","timestamp":1500296988000},"page":"259-268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["International Endometrial Tumor Analysis (IETA) terminology in women with postmenopausal bleeding and sonographic endometrial thickness\u2009\u2265\u20094.5\u2009mm: agreement and reliability study"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9563-8135","authenticated-orcid":false,"given":"P.","family":"Sladkevicius","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Sk\u00e5ne University Hospital Malm\u00f6, Lund University  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