Interobserver Agreement and Intersystem Comparison of the Halfway System of Baden and Walker Versus the Pelvic Organ Prolapse???Quantitation Prolapse Classification System in Assessing the Severity of Pelvic Organ Prolapse

In Brief Objective: The objective of this study was to assess the interobserver and intersystem agreement of the Baden and Walker (B&W) and the Pelvic Organ Prolapse–Quantitation (POP-Q) systems. Methods: Fifty patients with primo pelvic organ prolapse were consecutively examined by 2 gynecologists according to the 2 systems. Results: The interobserver agreement (weighted kappa [Kw]) of the Baden and Walker system was 0.76 for cystocele, 0.71 for prolapse of the uterus, 0.50 for rectocele, and 0.37 for enterocele. Overall, the interobserver agreement of the POP-Q centimeter scores, analyzed by Spearman's rank correlation coefficient, was good for the anterior and middle compartment and poor for the posterior compartment. The interobserver agreement of the overall stage of the POP-Q system based on the leading edge of the prolapse was Kw 0.33. The intersystem agreement between B&W and POP-Q systems was moderate for the middle compartment (Kw 0.64 and 0.44), fair for the anterior compartment (Kw 0.23 and 0.35), and poor for the posterior compartment (Kw 0.11 and 0.12). Conclusion: The interobserver variation of the Baden Walker and POP-Q systems proved to be similar and the intersystem variation between the 2 systems moderately strong. The systems are not completely interchangeable. The interobserver and intersystem agreement of the POP-Q and the Baden and Walker systems were assessed. The interobserver agreement of the POP-Q and the Baden and Walker systems proved to be similar. The intersystem agreement between the two systems was moderately strong.