| Interrater agreement of nasal endoscopy for chronic rhinosinusitis. | |
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MedLine Citation:
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PMID: 22253129 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Nasal endoscopy is a routine, important diagnostic tool in the evaluation of chronic rhinosinusitis (CRS). Although the procedure is ideally "objective," the subjective nature of endoscopy interpretation and lack of standardization are potential limitations. The goal of this study was to examine the interrater agreement of various categories of nasal endoscopy findings in patients undergoing evaluation for CRS. METHODS: Fourteen patients (28 sides) with CRS underwent clinical evaluation, SNOT-22, sinus computed tomography (CT), and digital video nasal endoscopy. Five academic rhinologists blindly reviewed the endoscopies for structural anatomic issues, inflammatory rhinosinusitis findings, and atypical lesions. Statistical comparison of the endoscopy interpretations was performed using the unweighted Fleiss' kappa statistic (K(f) ). RESULTS: The mean Lund-Mackay CT scan score was 7.8 (standard deviation [SD] 4.9) and the mean SNOT-22 score was 35.8 (SD 22.7). Significant variability was noted among the raters with respect to the various categories of nasal endoscopy findings. The overall levels of interrater agreement for the various categories were as follows: "almost perfect" for atypical lesions (K(f) = 0.912); "substantial" for nasal polyps (K(f) = 0.693); "moderate" for nasal discharge (K(f) = 0.422) and mucosal inflammatory changes of the middle turbinate (K(f) = 0.413); and "fair" for edema of the middle meatus (K(f) = 0.214), obstruction by nasal septum deviation (K(f) = 0.240), and obstruction by the middle turbinate (K(f) = 0.276). CONCLUSION: Significant variability was noted in the interrater agreement for nasal endoscopy findings in this study, with relatively limited agreement on some of the key findings of the procedure. Additional investigation and standardization of nasal endoscopy interpretation is required to improve the clinical utility of the procedure. © 2011 ARS-AAOA, LLC. |
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Authors:
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Roheen Raithatha; Vijay K Anand; Jess C Mace; Timothy L Smith; Madeleine R Schaberg; Gurston G Nyquist; Peter H Hwang; Brent A Senior; James A Stankiewicz; Abtin Tabaee |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-17 |
Journal Detail:
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Title: International forum of allergy & rhinology Volume: - ISSN: 2042-6984 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101550261 Medline TA: Int Forum Allergy Rhinol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC. |
Affiliation:
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Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, NY. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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