{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:54:14Z","timestamp":1747184054548,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,15]],"date-time":"2023-08-15T00:00:00Z","timestamp":1692057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Defaecating proctogram (DP) studies have become an integral part of the evaluation of patients with pelvic floor disorders. However, their impact on treatment decision\u2010making remains unclear. The aim of this study was to assess the concordance of decision\u2010making by colorectal surgeons and the role of the DP in this process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Four colorectal surgeons were presented with online surveys containing the complete history, examination and investigations of 106 de\u2010identified pelvic floor patients who had received one of three treatment options: physiotherapy only, anterior Delorme's procedure or anterior mesh rectopexy. The survey assessed the management decisions made by each of the surgeons for the three treatments both before and after the addition of the DP to the diagnostic work\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After the addition of the DP results; treatment choice changed in 219 (52%) of 424 surgical decisions and interrater agreement improved significantly from <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.26 to <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.39. Three of the four surgeons reported a significant increase in confidence. Agreement with the actual treatments patients received increased from <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.21 to <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.28. Intra\u2010anal rectal prolapse on DP was a significant predictor of a decision to perform anterior mesh rectopexy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The DP improves interclinician agreement in the management of pelvic floor disorders and enhances the confidence in treatment decisions. Intra\u2010anal rectal prolapse was the most influential DP parameter in treatment decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16706","type":"journal-article","created":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T15:51:36Z","timestamp":1692201096000},"page":"1994-2000","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The influence of defaecating proctograms on clinical decision\u2010making in pelvic floor disorders"],"prefix":"10.1111","volume":"25","author":[{"given":"Leanora","family":"Gomes","sequence":"first","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7369-8639","authenticated-orcid":false,"given":"Chris","family":"Varghese","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rowan J.","family":"Collinson","sequence":"additional","affiliation":[{"name":"Department of Surgery Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian L.","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Surgery Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan R.","family":"Parry","sequence":"additional","affiliation":[{"name":"Department of Surgery Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Milne","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6530-2454","authenticated-orcid":false,"given":"Ian P.","family":"Bissett","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0b013e3181b12e01"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31822dd0f0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.01886.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01208.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.30.12.1737"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4236\/ojgas.2012.22009"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236560"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050207"},{"key":"e_1_2_10_10_1","first-page":"273","article-title":"Interobserver agreement in defecography\u2014an international study","volume":"36","author":"M\u00fcller\u2010Lissner SA","year":"1998","journal-title":"Z Gastroenterol"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2011.17.4.416"},{"key":"e_1_2_10_12_1","unstructured":"R Core Team.R: A Language and Environment for Statistical Computing. 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