Visual-Numeric Endometriosis Scoring System (VNESS) for mapping surgical
findings: A validation study.
Objective The aim of this study was to assess inter-rater
reliability for components of the Visual-Numeric Endometriosis Scoring
System (VNESS). VNESS is a novel system for describing surgical findings
in each compartment of the pelvis in a way that is simple to use,
visually intuitive and mirrors a laparoscopic image of the pelvis.
Design Validation study using short surgical laparoscopic video
clips. Setting Anonymized video clips of endometriosis surgery
scored by 50 Gynaecologists from 12 countries. Population
Gynaecologists as scores of short surgical clips selected from a series
of endometriosis procedures performed between 2012 and 2022.
Methods 50 gynaecologists scored 93 short surgical videoclips
using VNESS. 4650 scores were compared against a reference score and
analysis was performed to assess inter-rater reliability. Main
outcome measures The outcome measures were percentage agreement between
given and reference scores, as well as intra-class correlation
coefficients (ICC), Cohen Kappa and Quadratic Weighted Kappa
Coefficients were calculated to evaluate inter-rater reliability.
Results The highest and lowest percentage agreement with the
reference score was seen in VNESS 4 (full thickness disease, 97%
perfect agreement) and VNESS 1 (superficial disease, 53% perfect
agreement) respectively. The intraclass correlation coefficient showed
strong inter-rater reliability for all VNESS compartments except the
vagina. Conclusions This study suggests that VNESS has
excellent inter-observer reliability. Correlation is stronger with more