1921
Volume 96, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Cystic echinococcosis (CE), a parasitic zoonosis, results in cyst formation in the viscera. Cyst morphology depends on developmental stage. In 2003, the World Health Organization (WHO) published a standardized ultrasound (US) classification for CE, for use among experts as a standard of comparison. This study examined the reliability of this classification. Eleven international CE and US experts completed an assessment of eight WHO classification images and 88 test images representing cyst stages. Inter- and intraobserver reliability and observer performance were assessed using Fleiss' and Cohen's kappa. Interobserver reliability was moderate for WHO images (κ = 0.600, < 0.0001) and substantial for test images (κ = 0.644, < 0.0001), with substantial to almost perfect interobserver reliability for stages with pathognomonic signs (CE1, CE2, and CE3) for WHO (0.618 < κ < 0.904) and test images (0.642 < κ < 0.768). Comparisons of expert performances against the majority classification for each image were significant for WHO (0.413 < κ < 1.000, < 0.005) and test images (0.718 < κ < 0.905, < 0.0001); and intraobserver reliability was significant for WHO (0.520 < κ < 1.000, < 0.005) and test images (0.690 < κ < 0.896, < 0.0001). Findings demonstrate moderate to substantial interobserver and substantial to almost perfect intraobserver reliability for the WHO classification, with substantial to almost perfect interobserver reliability for pathognomonic stages. This confirms experts' abilities to reliably identify WHO-defined pathognomonic signs of CE, demonstrating that the WHO classification provides a reproducible way of staging CE.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.16-0659
2017-03-08
2018-12-11
Loading full text...

Full text loading...

/deliver/fulltext/14761645/96/3/686.html?itemId=/content/journals/10.4269/ajtmh.16-0659&mimeType=html&fmt=ahah

References

  1. Thompson RCA, McManus DP, Eckert J, Gemmell MA, Meslin F-X, Pawlowski ZS, , 2001. Aetiology: parasites and life-cycles. , eds. WHO/OIE Manual on Echinococcosis in Humans and Animals: A Public Health Problem of Global Concern. Paris, France: World Organisation for Animal Health (Office International des Epizooties), 119. [Google Scholar]
  2. Brunetti E, Garcia HH, Junghanss T, , 2011. Cystic echinococcosis: chronic, complex, and still neglected. PLoS Negl Trop Dis 5: e1146.[Crossref] [Google Scholar]
  3. Kern P, , 2003. Echinococcus granulosus infection: clinical presentation, medical treatment and outcome. Langenbecks Arch Surg 388: 413420.[Crossref] [Google Scholar]
  4. Romig T, Zeyhle E, Macpherson CN, Rees PH, Were JB, , 1986. Cyst growth and spontaneous cure in hydatid disease. Lancet 1: 861.[Crossref] [Google Scholar]
  5. Keshmiri M, Baharvahdat H, Fattahi SH, Davachi B, Dabiri RH, Baradaran H, Ghiasi T, Rajabimashhadi MT, Rajabzadeh F, , 1999. A placebo controlled study of albendazole in the treatment of pulmonary echinococcosis. Eur Respir J 14: 503507.[Crossref] [Google Scholar]
  6. Rogan MT, Hai WY, Richardson R, Zeyhle E, Craig PS, , 2006. Hydatid cysts: does every picture tell a story? Trends Parasitol 22: 431438.[Crossref] [Google Scholar]
  7. Larrieu E, Del Carpio M, Mercapide CH, Salvitti JC, Sustercic J, Moguilensky J, Panomarenko H, Uchiumi L, Herrero E, Talmon G, Volpe M, Araya D, Mujica G, Mancini S, Labanchi JL, Odriozola M, , 2011. Programme for ultrasound diagnoses and treatment with albendazole of cystic echinococcosis in asymptomatic carriers: 10 years of follow-up of cases. Acta Trop 117: 15.[Crossref] [Google Scholar]
  8. Frider B, Larrieu E, Odriozola M, , 1999. Long-term outcome of asymptomatic liver hydatidosis. J Hepatol 30: 228231.[Crossref] [Google Scholar]
  9. Gil-Grande LA, Rodriguez-Caabeiro F, Prieto JG, Sánchez-Ruano JJ, Brasa C, Aguilar L, García-Hoz F, Casado N, Bárcena R, Alvarez AI, , 1993. Randomised controlled trial of efficacy of albendazole in intra-abdominal hydatid disease. Lancet 342: 12691272.[Crossref] [Google Scholar]
  10. Hosch W, Junghanss T, Stojkovic M, Brunetti E, Heye T, Kauffmann GW, Hull WE, , 2008. Metabolic viability assessment of cystic echinococcosis using high-field 1H MRS of cyst contents. NMR Biomed 21: 734754.[Crossref] [Google Scholar]
  11. WHO Informal Working Group, 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 85: 253261.[Crossref] [Google Scholar]
  12. Macpherson CN, Bartholomot B, Frider B, , 2003. Application of ultrasound in diagnosis, treatment, epidemiology, public health and control of Echinococcus granulosus and E. multilocularis . Parasitology 127 (Suppl): S21S35.[Crossref] [Google Scholar]
  13. Macpherson CN, Milner R, , 2003. Performance characteristics and quality control of community based ultrasound surveys for cystic and alveolar echinococcosis. Acta Trop 85: 203209.[Crossref] [Google Scholar]
  14. Macpherson CN, Romig T, Zeyhle E, Rees PH, Were JB, , 1987. Portable ultrasound scanner versus serology in screening for hydatid cysts in a nomadic population. Lancet 2: 259261.[Crossref] [Google Scholar]
  15. Brunetti E, Kern P, Vuitton DA, , 2010. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 114: 116.[Crossref] [Google Scholar]
  16. Microsoft, 2010. Microsoft Excel. Redmond, WA: Microsoft. [Google Scholar]
  17. Landis JR, Koch GG, , 1977. The measurement of observer agreement for categorical data. Biometrics 33: 159174.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0659
Loading
/content/journals/10.4269/ajtmh.16-0659
Loading

Data & Media loading...

  • Received : 12 Aug 2016
  • Accepted : 05 Dec 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error